SARS-CoV-2-INDUCED MICROSCOPIC POLYANGIITIS: CLINICAL PROBLEM
Introduction. During the COVID-19 pandemic, the diagnosis and treatment of ANCA-associated vasculitis (AAV) have been discussed in different ways. At the same time, the authors of many foreign publications state that SARS-CoV-2 infection can be another viral trigger for the development of AAV in chi...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative Department
2025-05-01
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| Series: | Клінічна та профілактична медицина |
| Subjects: | |
| Online Access: | https://cp-medical.com/index.php/journal/article/view/599 |
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| Summary: | Introduction. During the COVID-19 pandemic, the diagnosis and treatment of ANCA-associated vasculitis (AAV) have been discussed in different ways. At the same time, the authors of many foreign publications state that SARS-CoV-2 infection can be another viral trigger for the development of AAV in children and adults.
Aim. To evaluate the clinical and pathomorphological features and the prognosis of the first diagnosed MPA co-occurred with PRS in the patient with a severe course of COVID-19.
Materials and methods. An extensive literature review, retrospective analysis and discussion of the clinical case of the patient with SARS-CoV-2 infection who simultaneously developed myeloperoxidase-ANCA positive MPA with PRS and COVID-19 have been carried out. Methods: description, comparative analysis, systematization of clinical case data, abstracting.
Results. In this study, we report the case of the 46-year-old patient with SARS-CoV-2 infection who developed rapidly progressive glomerulonephritis complicated by the acute kidney injury and pulmonary capillaritis, and on the basis of the results of clinical, laboratory, radiological and serological tests and the exclusion of mimic diseases subsequently (after 5 months) myeloperoxidase-ANCA-positive MPA was diagnosed. To induce remission, the patient was started on pathogenetic initial immunosuppressive therapy. Unfortunately, the acute course of the disease and joining the intercurrent infection along with the late-started immunosuppressive therapy significantly worsened the course of the disease, which caused death from multiple organ failure due to septic shock.
The diagnosis of de novo ANCA-associated vasculitis can be difficult in the context of severe COVID-19 infection due to the common anatomic sites of infection and inflammation. In addition, some symptoms and clinical manifestations of both diseases are common. Consequently, the early diagnosis of MPA during the COVID-19 pandemic for the clinicians of various specialties remains as difficult as it was before it. Since MPA is a systemic vasculitis, multiple organ involvement can result in a wide range of signs and symptoms.
Conclusions. A quick diagnosis of MPA and early start of immunosuppressive therapy can save both the patient’s life and organs. In the current conditions of the global pandemic of COVID-19, MPA should be high on the differential diagnosis of patients who are currently infected or have been infected with SARS-CoV-2 and PRS. |
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| ISSN: | 2616-4868 |