IgA Vasculitis: Etiology, Treatment, Biomarkers and Epigenetic Changes

Sugino, Hitomi; Sawada, Yu; Nakamura, Motonobu

doi:10.3390/ijms22147538

Cited by 47 publications

(52 citation statements)

References 135 publications

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“…It is possible that, after administration of the COVID-19 vaccine, immune complexes may form between vaccine antigens and native antibodies, thereby initiating a vasculitic process, as previously observed for other vaccinations [30]. IgA is driven in response to external stimuli and aberrant IgA responses underlie the pathogenesis of IgA vasculitis; IgA activates mannan-binding lectin and alternative complement pathways after creating IgA immunocomplexes and deposition on small vessels [11]. In the case reported, the problem of the booster dose was also addressed: should it be administered or not?…”

Section: Discussionmentioning

confidence: 91%

“…Many types of viruses and bacteria are believed to be associated with the pathogenesis of IgA vasculitis, as they have the capacity to induce abnormal IgA autoimmune reactions in the host. The COVID-19 pandemic is recognized to cause vasculitis-like syndromes, and several reports have described COVID-19 associated IgA vasculitis [11]. HSP has been previously reported following immunization with various vaccines, mostly within 12 weeks post vaccination [5].…”

Section: Mandatory Criterionmentioning

confidence: 99%

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Henoch-Schönlein Purpura Following the First Dose of COVID-19 Viral Vector Vaccine: A Case Report

et al. 2021

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A 76 year-old female came to our observation one week after the vaccination with ChAdOx1 nCoV-19 AZD1222 for the onset of purpuric rash on her gluteal and legs regions associated with coxalgia and episodes of macrohaematuria. Henoch-Schönlein purpura (HSP) was diagnosed on the basis of the revised criteria developed by the European League Against Rheumatism, the Paediatric Rheumatology International Trials Organization, and the Paediatric Rheumatology European Society (EULAR/PRINTO/PRES). HSP is a common IgA-mediated small vessel vasculitis, typical of childhood, that affects several systems and is characterized by a tetrad of dermatological, abdominal, joint, and renal manifestations. The Etiology of HSP is not completely understood, but it was observed following upper respiratory tract infections, medications, vaccinations, and malignancies. HSP has previously been reported following immunization with various vaccines, mostly within 12 weeks post, suggesting a possible correlation. To our knowledge, this is the first report of the possible association between COVID-19 ChAdOx1 nCoV-19 AZD1222 and the onset of HSP in a previously healthy woman. No similar cases were reported amongst 23.848 participants in the ChAdOx1 nCoV-19 AZD1222 trial.

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Section: Discussionmentioning

confidence: 91%

Section: Mandatory Criterionmentioning

confidence: 99%

Henoch-Schönlein Purpura Following the First Dose of COVID-19 Viral Vector Vaccine: A Case Report

et al. 2021

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“…The cytokines released in COVID-19 (such as IL-1, IL-6, and TNF) can also potentially lead to the proliferation and maturation of these IgA1-producing B cells, hence leading to IgAN. 51 , 52 , 53 …”

Section: Discussionmentioning

confidence: 99%

The pathogenesis of COVID-19-induced IgA nephropathy and IgA vasculitis: A systematic review

Farooq

Rehman

Asmar

et al. 2022

Journal of Taibah University Medical Sciences

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Objective IgA nephropathy (IgAN) and IgA vasculitis (IgAV) are part of a similar clinical spectrum. Both clinical conditions occur with the coronavirus disease 2019 (COVID-19). This review aims to recognize the novel association of IgAN and IgAV with COVID-19 and describe its underlying pathogenesis. Methods We conducted a systematic literature search and data extraction from PubMed, Cochrane, ScienceDirect, and Google Scholar following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results Our search identified 13 cases reporting IgAV and IgAN associated with COVID-19 infection and 4 cases of IgAN following COVID-19 vaccination. The mean, mode, and median ages of patients were 23.8, 4, and 8 years, respectively. Most cases associated with COVID-19 infection were reported in males (76.9%). Rash and purpura (84.6%) were the most common clinical features, followed by gastrointestinal symptoms (61.5%). In symptomatic cases, skin or renal biopsy and immunofluorescence confirmed the diagnosis of IgAN or IgAV. Most patients were treated with steroids and reported recovery or improvement; however, death was reported in two patients. Conclusion There is a paucity of scientific evidence on the pathogenesis of the association of IgAN and IgAV vasculitis with COVID-19, which thus needs further study. Current research suggests the role of IgA-mediated immune response, evidenced by early seroconversion to IgA in COVID-19 patients and the role of IgA in immune hyperactivation as the predominant mediator of the disease process. Clinicians, especially nephrologists and paediatricians, need to recognize this association, as this disease is usually self-limited and can lead to complete recovery if prompt diagnosis and treatment are provided.

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“…In the geriatric population, cases are even more sparse with true prevalence rates being relatively unknown. Cases have a triggering etiology which is often infectious, drug-induced or malignant [ 2 , 3 ]. Paraneoplastic cases have been reported in the literature but are considered rare.…”

Section: Introductionmentioning

confidence: 99%

Paraneoplastic IgA Vasculitis in an Older Adult With Metastatic Lung Adenocarcinoma

Farzam

Syed

2021

Cureus

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Immunoglobulin A (IgA) vasculitis is a rare disease in the older adult patient population. It is often triggered by an underlying etiology such as infection or malignancy. Paraneoplastic cases have been reported in the geriatric population in literature but the exact prevalence is unknown. Diagnosis requires satisfaction of both clinical and laboratory criteria, with additional emphasis on finding an underlying etiology. Treatment is focused on supportive care and may include immunosuppressive therapy. However, targeting the primary cause is also important for improving outcomes. Our patient in this report presented with a novel case of paraneoplastic IgA vasculitis that likely occurred secondary to lung adenocarcinoma.

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IgA Vasculitis: Etiology, Treatment, Biomarkers and Epigenetic Changes

Cited by 47 publications

References 135 publications

Henoch-Schönlein Purpura Following the First Dose of COVID-19 Viral Vector Vaccine: A Case Report

Henoch-Schönlein Purpura Following the First Dose of COVID-19 Viral Vector Vaccine: A Case Report

The pathogenesis of COVID-19-induced IgA nephropathy and IgA vasculitis: A systematic review

Paraneoplastic IgA Vasculitis in an Older Adult With Metastatic Lung Adenocarcinoma

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