Henoch–Schoenlein Purpura Following Severe Acute Respiratory Syndrome Coronavirus-2 Infection: A Case Report and Short Review of Histopathological Changes in Dermis

Soleiman-Meigooni, Saeed; Hamidi-Farahani, Ramin; Ahmadi, Mousa; Asgari, Ali; Yaghmaee, Ramin

doi:10.22541/au.161148965.52528385/v1

Cited by 3 publications

(3 citation statements)

References 3 publications

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“…This is in similarity to MIS-C, in which median age of presentation is in older children compared to Kawasaki disease (29). Moreover, there are multiple case reports and case series on COVID-19 associated IgA vasculitis and IgA nephropathy in adults in the literature (30)(31)(32)(33)(34)(35)(36)(37)(38). COVID-19 associated HSP was more common in males than in females with a ratio of 3:1, in comparison to non-COVID-19 associated IgA vasculitis, in which the ratio is 1.5:1 (1).…”

Section: Discussionmentioning

confidence: 70%

IgA Vasculitis and COVID-19 in Children: A Systematic Review

Lecea

Abisad

Paredes

et al. 2021

Preprint

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Background: Immunoglobulin A vasculitis is the most common form of vasculitis in children. The diagnosis is made clinically and patients will present with a rash, together with gastrointestinal, musculoskeletal, and renal system involvement. Progress in the classification of the systemic vasculitides has facilitated better understanding of the pathogenesis underlying these inflammatory conditions. Over the past year, several cases of IgA vasculitis have been reported in both children and adults in association with SARS-CoV2 infection, raising the question of whether there is any causal or even a synergistic association.Methods: This systematic review was performed following the guidelines of Meta-analysis of Observational Studies in Epidemiology. A literature search was conducted using MEDLINE, SciELO and Google Scholar using the search terms “COVID-19” or “SARS-CoV-2" in combination with “IgA vasculitis”, or “Henoch-Schonlein Purpura”. We considered articles to be eligible for inclusion if they reported a case report or series of cases of IgA vasculitis associated with proven COVID-19 infection. We excluded cases from further review if the case reported was a patient older than 18 years. WHO causality assessment categories were used to standardize case causality. Results: After reviewing the complete article and applying our exclusion criteria, 12 articles describing 12 cases of COVID-19 associated IgA vasculitis in children were included. In 83% of the cases the diagnosis of COVID-19 was made on presentation of IgA symptoms or on presentation to seek medical care. In 17% of cases the SARS Cov-2 test was positive before IgA vasculitis symptoms presentation. The mean age of the patients was 7.3 years of age (SD ±4.8). Male to female ratio was 3:1. Lower extremity purpura was present in all 12 patients. Gastrointestinal manifestations were present in 7 patients. Oligoarthritis was present in 7 patients. Three patients presented renal involvement with hematuria/proteinuria. Conclusions: During the pandemic, several autoimmune phenomena have been described to co-occur with or following COVID-19. The exact role of COVID-19 in the development of these IgA-related diseases is still being explored. Our review of case series and case reports with standardized causality assessment identified 12 cases of IgA vasculitis associated with COVID-19 infection in children.

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Section: Discussionmentioning

confidence: 70%

IgA Vasculitis and COVID-19 in Children: A Systematic Review

Lecea

Abisad

Paredes

et al. 2021

Preprint

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“…In the second selection round, full-text articles of the remaining papers were assessed. For the final analysis, we retained 67 reports [ [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , <...…”

Section: Resultsmentioning

confidence: 99%

“…Data are presented as frequency or as median with interquartile range. Vaccination-associated Infection-associated P-value N 17 23 Males: females, N 9:8 16 : 7 0.503 Age, years of age 60 [ [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] ] 13 [ [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , …”

Section: Resultsmentioning

confidence: 99%

Coronavirus disease 2019, vaccination against coronavirus and immunoglobulin A-mediated diseases: systematic literature review

Bronz¹,

Faré²,

Lava³

et al. 2022

Journal of Autoimmunity

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Henoch–schonlein purpura following exposure to SARS-CoV2 vaccine or infection: a systematic review and a case report

Di Vincenzo,

Ennas,

Pizzoferrato

et al. 2023

Intern Emerg Med

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Background Henoch–Schonlein purpura (HSP) is an IgA-mediated systemic small-vessel vasculitis (IgAV) that typically presents with a variable tetrad of symptoms. HSP if often preceded by respiratory tract infections, vaccinations, drugs or malignancies. During the recent COVID-19 pandemic multiples cases of HSP have been described after both infection and vaccination for SARS-CoV2. This study aims to perform a systematic review of literature and describe an additional complicated case of de-novo HSP appeared after the administration of the third dose of a mRNA-SARS-CoV2 vaccination. Methods Electronic bibliographic research was performed to identify all the original reports describing cases of de-novo HSP or IgAV appeared after respiratory infection or vaccine administration for SARS-CoV2. We included all case series or case reports of patients who respected our inclusion and exclusion criteria. Results Thirty-eight publications met our pre-defined inclusion criteria, for an overall number of 44 patients. All patients presented with palpable purpura variable associated with arthralgia, abdominal pain or renal involvement. Increased levels of inflammation markers, mild leukocytosis and elevated D-dimer were the most common laboratory findings. Up to 50% of patients presented proteinuria and/or hematuria. Almost all skin biopsies showed leukocytoclastic vasculitis, with IgA deposits at direct immunofluorescence in more than 50% of cases. Conclusions Our results suggest that the immune response elicited by SARS-CoV2 vaccine or infection could play a role in the development of HSP. Current research suggests a possible role of IgA in immune hyperactivation, highlighted by early seroconversion to IgA found in some COVID-19 patients who develop IgA vasculitis.

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Henoch–Schoenlein Purpura Following Severe Acute Respiratory Syndrome Coronavirus-2 Infection: A Case Report and Short Review of Histopathological Changes in Dermis

Cited by 3 publications

References 3 publications

IgA Vasculitis and COVID-19 in Children: A Systematic Review

IgA Vasculitis and COVID-19 in Children: A Systematic Review

Coronavirus disease 2019, vaccination against coronavirus and immunoglobulin A-mediated diseases: systematic literature review

Henoch–schonlein purpura following exposure to SARS-CoV2 vaccine or infection: a systematic review and a case report

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