Kataria Saurabh, Rogers Sylvette, Sadia Haleema, Ali Tooba, Qureshi Hasham M, Bano Shehar, Anigbo Chinyere L, Singh Romil
Neurology, Ochsner Louisiana State University Health Sciences Center, Shreveport, USA.
Neurology and Neurocritical Care, University of Missouri Health Care, Columbia, USA.
Cureus. 2022 Jun 20;14(6):e26111. doi: 10.7759/cureus.26111. eCollection 2022 Jun.
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is a class of autoimmune diseases that can cause kidney failure because of mononuclear cell infiltration and the destruction of small and medium-sized blood vessels. Coronavirus disease 2019 (COVID-19) may trigger or exacerbate autoimmune diseases. We present a case of ANCA-associated vasculitis in a patient with rheumatoid arthritis after a COVID-19 infection, who presented with intermittent hemoptysis and dyspnea and was diagnosed with COVID-19 pneumonia three weeks ago. Her clinical, radiological, and serological picture was concerned with pulmonary-renal syndrome. Her serum was positive for antinuclear antibody and ANCAs, and renal biopsy showed pauci-immune crescentic glomerulonephritis. She was diagnosed clinicopathologically with pauci-immune glomerulonephritis in the setting of rheumatoid arthritis (RA) after a COVID-19 infection. Her condition improved after she was treated with rituximab and pulse dose methylprednisolone.
抗中性粒细胞胞浆抗体（ANCA）相关血管炎是一类自身免疫性疾病，可因单核细胞浸润及中小血管破坏而导致肾衰竭。2019冠状病毒病（COVID-19）可能引发或加重自身免疫性疾病。我们报告一例类风湿关节炎患者在感染COVID-19后发生ANCA相关血管炎的病例，该患者出现间歇性咯血和呼吸困难，三周前被诊断为COVID-19肺炎。其临床、影像学和血清学表现符合肺肾综合征。她的血清抗核抗体和ANCA呈阳性，肾活检显示寡免疫性新月体性肾小球肾炎。经临床病理诊断，她在感染COVID-19后患有类风湿关节炎（RA）合并寡免疫性肾小球肾炎。在接受利妥昔单抗和脉冲剂量甲泼尼龙治疗后，她的病情有所改善。
