New-Onset ANCA-Associated Vasculitis in a Patient with SARS-COV2

Cobilinschi, Claudia; Cobilinschi, Cristian; Constantinescu, Alexandra; Draniceanu, Iuliana; Ionescu, Ruxandra

doi:10.5152/balkanmedj.2021.21129

Cited by 7 publications

(9 citation statements)

References 4 publications

(4 reference statements)

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“…Among the 25 cases, we found in the literature (median age of 49 years with 13 females) (Table 2), AAV was diagnosed one to six months after COVID-19 in 12 patients [11,[16][17][18][19][20][21][22][23][24][25][26] while COVID-19 and AAV were diagnosed during the same admission in 11 cases [5,[27][28][29][30][31][32][33][34][35][36]. It is noteworthy that severe AAV with life-threatening alveolar haemorrhage can follow a mild COVID-19 infection, exemplified by two patients who had mild COVID-19 (managed with self-quarantine but not requiring hospital admission) but subsequently died following pulmonary haemorrhage [12,21].…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 Infection: A Forerunner or Precursor in Anti-neutrophil Cytoplasmic Antibody-Associated Vasculitis With Kidney Injury

Aung¹,

Oluyombo²,

Karim³

et al. 2022

Cureus

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COVID-19 disease and anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis are both multisystemic conditions. It is postulated there is a causal relationship between both conditions and this is supported by some case reports. The symptoms of COVID-19 can mimic those of vasculitis especially when the respiratory system is affected. Early diagnosis and treatment of ANCA-vasculitis cannot be overemphasized as this reduces the risk of severe organ damage. We report a 64-year-old lady with SARS-CoV-2 infection who developed ANCA-vasculitis with acute kidney injury and we reviewed the literature on this plausible association.We performed an electronic search of the MEDLINE, EMBASE, CINAHL, and EMCARE databases for research studies and case series and reports published in the English language between April 2020 and February 2022. Our review suggests that patients with COVID-19 infection who had proteinase 3-ANCA positive vasculitis with diffuse alveolar haemorrhage had fatal outcomes. We also noticed an increased incidence of active urine sediments. We emphasize the importance of a high index of suspicion for diagnosis and early treatment of vasculitis to ensure an improved outcome.

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Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 Infection: A Forerunner or Precursor in Anti-neutrophil Cytoplasmic Antibody-Associated Vasculitis With Kidney Injury

Aung¹,

Oluyombo²,

Karim³

et al. 2022

Cureus

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“…Our case involves a previously healthy male who developed AAV that was likely triggered by post-COVID-19 hyperinflammatory syndrome as suggested by the continuously elevated ferritin and triglycerides. Only a few case reports in the literature have described the incidence of AAV following COVID-19 infection, and none of the reported cases share similar cutaneous manifestations of AAV in the form of hemorrhagic bullae as in our patient [5][6][7][8][9][10][11][12][13]. In addition, none of the reported cases had oral mucosal involvement.…”

Section: Discussionmentioning

confidence: 65%

Antineutrophil Cytoplasmic Autoantibody (ANCA)-Associated Vasculitis With Mucosal Involvement Following COVID-19 Pneumonia

Ta¹,

Awada²,

Kang³

et al. 2022

Cureus

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Antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitides (AAV) are a group of inflammatory disorders in which autoantibodies damage small arteries throughout the body, including in the upper and lower respiratory system, kidneys, as well as the skin. AAV may be precipitated by a variety of causes, including infections. In this report, we examine the case of a patient who developed AAV that was suspected primarily based on mucocutaneous hemorrhagic bullae, elevated ANCA levels, and subsequently confirmed by kidney biopsy, while recovering from coronavirus disease 2019 (COVID-19) infection. AAV and COVID-19 infections may present with similar symptoms, rendering an accurate diagnosis challenging. Additionally, only a few other cases describing a similar onset of AAV post-COVID-19 infection have been described in the literature. Initial presenting features of AAV in such cases have varied considerably, which makes the diagnosis even more challenging. We also engage in a review of such cases to assess key similarities, different treatment options, and outcomes. Lastly, the fact that several mechanisms have been proposed for AAV highlights the need for continued research to help clarify the pathophysiology while also identifying the optimal therapy.

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“…These reactions are responsible for most of the symptoms of an induced autoimmune disease after COVID-19 infection. 15,16 There can be other mechanisms besides vasculitis that can justify the neurological presentations. COVID-19 has been associated with vascular issues, including blood clot formation.…”

Section: Discussionmentioning

confidence: 99%

“…It activates the inflammatory cascade and causes tissue destruction and organ failure. These reactions are responsible for most of the symptoms of an induced autoimmune disease after COVID‐19 infection 15,16 …”

Section: Discussionmentioning

confidence: 99%

New‐onset ANCA‐associated vasculitis presenting with neuropathy after COVID‐19 infection: A case report and literature review

Mohamadi,

Soroureddin,

Nayebirad

et al. 2024

Clinical Case Reports

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Key Clinical MessageCoronavirus Disease 2019 (COVID‐19) is a viral infection caused by SARS‐CoV‐2, which can trigger autoimmune diseases such as antineutrophilic cytoplasmic antibody (ANCA) associated vasculitis (AAV) that affect small and medium‐sized blood vessels in multiple organs. This study discusses a case with neuropathy and positive ANCA after COVID‐19 infection and reviews the literature on AAV following COVID‐19 infection. A 59‐year‐old man is presented that was referred to Shariati Hospital for evaluation of neurologic problems after a COVID‐19 infection. Initially, he had flu‐like symptoms. A few days later, he developed right distal upper and lower limb paresthesia. His electromyography (EMG) and nerve conduction velocity (NCV) results were consistent with polyneuropathy. Lumbar puncture (LP) was normal except for positive COVID‐19 polymerase chain reaction (PCR). The patient's paresthesia worsened. Laboratory data showed leukocytosis, anemia, thrombocytosis, high erythrocyte sedimentation rate (ESR), and C‐reactive protein (CRP). Perinuclear anti‐neutrophil cytoplasmic antibody (MPO‐ANCA) was positive. According to the results, vasculitis was the main differential diagnosis. The sural nerve biopsy was performed, and the result was consistent with small to medium‐sized vessel vasculitis. The patient was diagnosed with COVID‐induced AAV. He was prescribed methylprednisolone and cyclophosphamide and was discharged with prednisolone and cotrimoxazole. In this study, a unique case of AAV induced by COVID‐19 infection confirmed by nerve biopsy is presented. A review of the literature found 48 cases of new‐onset AAV in adults and pediatrics after COVID‐19 infection. Further research is needed to completely understand the relationship between COVID‐19.

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New-Onset ANCA-Associated Vasculitis in a Patient with SARS-COV2

Cited by 7 publications

References 4 publications

SARS-CoV-2 Infection: A Forerunner or Precursor in Anti-neutrophil Cytoplasmic Antibody-Associated Vasculitis With Kidney Injury

SARS-CoV-2 Infection: A Forerunner or Precursor in Anti-neutrophil Cytoplasmic Antibody-Associated Vasculitis With Kidney Injury

Antineutrophil Cytoplasmic Autoantibody (ANCA)-Associated Vasculitis With Mucosal Involvement Following COVID-19 Pneumonia

New‐onset ANCA‐associated vasculitis presenting with neuropathy after COVID‐19 infection: A case report and literature review

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