Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is an umbrella of autoimmune diseases that cause inflammation or damage to small blood vessels, according to Vasculitis UK. Small blood vessels are found everywhere in the body, particularly in the lungs, joints, ears, nose, and nerves.
A case study of a 79-year-old woman with ischemic heart disease and rheumatoid arthritis (RA) shows that COVID-19 may trigger or exacerbate autoimmune diseases, such as ANCA-associated vasculitis. Read on to learn more about this case.
Case Study Highlights How COVID-19 May Trigger Onset of ANCA-Related Vasculitis
Anti-Neutrophil Cytoplasmic Antibody (ANCA)-Related Vasculitis Post-COVID-19
The paper titled "Antineutrophil Cytoplasmic Antibody (ANCA)-Associated Renal Vasculitis After COVID-19 Infection: A Case Report," reported in Cureus, discusses a case of ANCA-associated vasculitis in a patient with rheumatoid arthritis after a COVID-19 infection whose clinical, radiological, and serological picture shows pulmonary-renal syndrome.
COVID-19 is among the infections that have been documented to cause acute kidney injury. However, an association between vasculitis and COVID-19 has been rarely documented even with previous reports of renal involvement due to coronavirus disease.
The woman in the case study was diagnosed with RA three years ago but was not compliant with her medications. She was admitted to the hospital after being diagnosed with COVID-19 pneumonia and was discharged four days later after her condition improved.
Before she went home, she underwent a series of laboratory tests, which are essential to test for low hemoglobin levels and increased creatinine and brain natriuretic peptide levels. Results showed that she had bilateral airspace disease and was given medication. However, there was a concern for pulmonary-renal syndrome because of her health history.
Additionally, doctors found that she had a normal kidney size but was positive for ANCAs and antinuclear antibodies. Her renal biopsy also revealed that she has pauci-immune glomerulonephritis in the setting of RA post-COVID-19 infection.
Renal involvement in RA is complex, with the most usual cause being secondary amyloidosis and medications. But the overlap of RA and renal limited ANCA-associated vasculitis is rare, with a prevalence of 21% reported.
In conclusion, the paper reported that the woman with pauci-immune glomerulonephritis when her RA started after a COVID-19 infection worsened her renal and pulmonary functions. But her condition improved after being treated with rituximab and pulse dose methylprednisolone. Therefore, the team recommends obtaining urine analysis and renal function tests in patients with RA.
Post-COVID-19 Complications
According to the Centers for Disease Control and Prevention (CDC), some people infected with the SARS-CoV-2 virus can experience long-term effects known as post-COVID conditions (PCC) or long COVID.
It could include a wide range of ongoing health problems that could last for weeks, months, or years. Long COVID is also more common in people who had severe COVID-19 illness, but anyone infected with coronavirus can experience it.
Those who have not been vaccinated yet against COVID-19 and became infected may be at higher risk of developing long COVID than those vaccinated and had breakthrough cases.
CDC and other health agencies are working together to understand further the experiences of post-COVID conditions, such as the case study, and include groups disproportionately affected by COVID-19.
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