ANCA vasculitis: A manifestation of Post-Covid-19 Syndrome

The SARS-CoV-2 infection has been found to present with different degrees of response and variable levels of inflammation. Patients who have recovered from the initial infection can develop long-term symptomatology. We present a unique case of a middle aged-healthy man who developed complications of...

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Autores principales:	Desiree Morris, Kushal Patel, Osman Rahimi, Omar Sanyurah, Alfredo Iardino, Nazia Khan
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	COVID-19 ANCA-Associated vasculitis Respiratory medicine Renal medicine Diseases of the respiratory system RC705-779
Acceso en línea:	https://doaj.org/article/f96d353e9244409dab76488cfe2a89dd
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spelling	oai:doaj.org-article:f96d353e9244409dab76488cfe2a89dd2021-11-14T04:32:38ZANCA vasculitis: A manifestation of Post-Covid-19 Syndrome2213-007110.1016/j.rmcr.2021.101549https://doaj.org/article/f96d353e9244409dab76488cfe2a89dd2021-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2213007121002112https://doaj.org/toc/2213-0071The SARS-CoV-2 infection has been found to present with different degrees of response and variable levels of inflammation. Patients who have recovered from the initial infection can develop long-term symptomatology. We present a unique case of a middle aged-healthy man who developed complications of ANCA-associated vasculitis after recovering from a mild COVID-19 infection.A previously healthy 53-year-old male presented with hemoptysis and acute renal failure. One month prior, the patient tested positive for COVID-19; not requiring hospitalization. Physical exam findings included bilateral lower extremity petechiae. CT Chest showed bilateral diffuse patchy lung consolidations with cavitary lesions with urinalysis revealing erythrocytes, +1 protein. Hemodialysis and workup for pulmonary-renal syndromes were initiated.Infectious workup results included: negative COVID-19, negative MTB-PCR, respiratory culture revealing yeast. Additional workup revealed; elevated CRP, D-Dimer, and Fibrinogen. Notably, the patient had; decreased C3 and C4 levels; negative Anti-GBM antibody; negative Anti-streptolysin-O; and positive ANCA assay, Proteinase antibody, and mildly positive Myeloperoxidase antibody.Worsening coagulopathy and atrophic kidneys delayed renal biopsy for definitive diagnosis. The patient's respiratory status acutely worsened during hemodialysis with imaging showing markedly increased pulmonary infiltrates. Upon urgent intubation, active frank red bleeding was noted, and the patient sustained 2 cardiac arrests with eventual expiration.Much is to be learned from the Novel SARS-CoV-2 virus and suspected complications. This case highlights a unique complication of COVID-19 leading to a possible AAV and the importance of keeping a broad differential when treating patients who have recovered from the initial infection.Desiree MorrisKushal PatelOsman RahimiOmar SanyurahAlfredo IardinoNazia KhanElsevierarticleCOVID-19ANCA-Associated vasculitisRespiratory medicineRenal medicineDiseases of the respiratory systemRC705-779ENRespiratory Medicine Case Reports, Vol 34, Iss , Pp 101549- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 ANCA-Associated vasculitis Respiratory medicine Renal medicine Diseases of the respiratory system RC705-779
spellingShingle	COVID-19 ANCA-Associated vasculitis Respiratory medicine Renal medicine Diseases of the respiratory system RC705-779 Desiree Morris Kushal Patel Osman Rahimi Omar Sanyurah Alfredo Iardino Nazia Khan ANCA vasculitis: A manifestation of Post-Covid-19 Syndrome
description	The SARS-CoV-2 infection has been found to present with different degrees of response and variable levels of inflammation. Patients who have recovered from the initial infection can develop long-term symptomatology. We present a unique case of a middle aged-healthy man who developed complications of ANCA-associated vasculitis after recovering from a mild COVID-19 infection.A previously healthy 53-year-old male presented with hemoptysis and acute renal failure. One month prior, the patient tested positive for COVID-19; not requiring hospitalization. Physical exam findings included bilateral lower extremity petechiae. CT Chest showed bilateral diffuse patchy lung consolidations with cavitary lesions with urinalysis revealing erythrocytes, +1 protein. Hemodialysis and workup for pulmonary-renal syndromes were initiated.Infectious workup results included: negative COVID-19, negative MTB-PCR, respiratory culture revealing yeast. Additional workup revealed; elevated CRP, D-Dimer, and Fibrinogen. Notably, the patient had; decreased C3 and C4 levels; negative Anti-GBM antibody; negative Anti-streptolysin-O; and positive ANCA assay, Proteinase antibody, and mildly positive Myeloperoxidase antibody.Worsening coagulopathy and atrophic kidneys delayed renal biopsy for definitive diagnosis. The patient's respiratory status acutely worsened during hemodialysis with imaging showing markedly increased pulmonary infiltrates. Upon urgent intubation, active frank red bleeding was noted, and the patient sustained 2 cardiac arrests with eventual expiration.Much is to be learned from the Novel SARS-CoV-2 virus and suspected complications. This case highlights a unique complication of COVID-19 leading to a possible AAV and the importance of keeping a broad differential when treating patients who have recovered from the initial infection.
format	article
author	Desiree Morris Kushal Patel Osman Rahimi Omar Sanyurah Alfredo Iardino Nazia Khan
author_facet	Desiree Morris Kushal Patel Osman Rahimi Omar Sanyurah Alfredo Iardino Nazia Khan
author_sort	Desiree Morris
title	ANCA vasculitis: A manifestation of Post-Covid-19 Syndrome
title_short	ANCA vasculitis: A manifestation of Post-Covid-19 Syndrome
title_full	ANCA vasculitis: A manifestation of Post-Covid-19 Syndrome
title_fullStr	ANCA vasculitis: A manifestation of Post-Covid-19 Syndrome
title_full_unstemmed	ANCA vasculitis: A manifestation of Post-Covid-19 Syndrome
title_sort	anca vasculitis: a manifestation of post-covid-19 syndrome
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/f96d353e9244409dab76488cfe2a89dd
work_keys_str_mv	AT desireemorris ancavasculitisamanifestationofpostcovid19syndrome AT kushalpatel ancavasculitisamanifestationofpostcovid19syndrome AT osmanrahimi ancavasculitisamanifestationofpostcovid19syndrome AT omarsanyurah ancavasculitisamanifestationofpostcovid19syndrome AT alfredoiardino ancavasculitisamanifestationofpostcovid19syndrome AT naziakhan ancavasculitisamanifestationofpostcovid19syndrome
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ANCA vasculitis: A manifestation of Post-Covid-19 Syndrome

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