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  1. Article ; Online: Acute ANCA Vasculitis and Asymptomatic COVID-19.

    Powell, Weston T / Campbell, Julie A / Ross, Francesca / Peña Jiménez, Patricia / Rudzinski, Erin R / Dickerson, Jane A

    Pediatrics

    2021  Volume 147, Issue 4

    Abstract: ... antineutrophil cytoplasmic antibody-associated vasculitis and associated diffuse alveolar hemorrhage who was positive for coronavirus ... We describe the presentation and diagnosis of a child with newly diagnosed ... that acute infection was not the cause of the patient's symptoms. Coronavirus disease 2019-induced ...

    Abstract We describe the presentation and diagnosis of a child with newly diagnosed antineutrophil cytoplasmic antibody-associated vasculitis and associated diffuse alveolar hemorrhage who was positive for coronavirus disease 2019 immunoglobulin G antibodies, indicative of a previous asymptomatic infection. Results of multiple polymerase chain reaction tests coinciding with the start of symptoms were negative, indicating that acute infection was not the cause of the patient's symptoms. Coronavirus disease 2019-induced autoimmune diseases have been described in adults, but this case report represents the first case described in a pediatric patient.
    MeSH term(s) Acute Disease ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/diagnosis ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/etiology ; Asymptomatic Diseases ; COVID-19/complications ; Child ; Female ; Humans
    Language English
    Publishing date 2021-01-20
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 207677-9
    ISSN 1098-4275 ; 0031-4005
    ISSN (online) 1098-4275
    ISSN 0031-4005
    DOI 10.1542/peds.2020-033092
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: A Case of Antineutrophil Cytoplasmic Antibody Vasculitis-Associated Acute Kidney Injury in a Patient With Asymptomatic COVID-19 Infection.

    Chandok, Taruna / Nasr, Rabih / Uday, Kalpana A

    Cureus

    2023  Volume 15, Issue 2, Page(s) e35006

    Abstract: ... in the setting of an asymptomatic COVID-19 infection. A kidney biopsy was done for declining renal function, and ... vasculitis (pauci-immune crescentic glomerulonephritis [GN]) superimposed on acute kidney injury caused by SARS-CoV-2 ... induced by the virus, infection by the virus itself and trauma to the epithelial vessels caused by the release ...

    Abstract Vasculitis, or inflammation of blood vessels, is commonly seen with severe acute respiratory syndrome Coronavirus disease 2 (SARS-CoV-2). It is usually triggered by an autoimmune response induced by the virus, infection by the virus itself and trauma to the epithelial vessels caused by the release of cytokines. We present a case of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (pauci-immune crescentic glomerulonephritis [GN]) superimposed on acute kidney injury caused by SARS-CoV-2. Our patient is a 57-year-old Hispanic female who presented with rising creatinine and active urinary sediment in the setting of an asymptomatic COVID-19 infection. A kidney biopsy was done for declining renal function, and positive myeloperoxidase antibodies revealed pauci-immune focal crescentic glomerulonephritis. Normalization of renal function was not achieved with pulse steroids and rituximab. The patient required long-term hemodialysis. Our case here adds to the very few cases of pauci-immune crescentic glomerulonephritis reported in patients with asymptomatic SARS-CoV-2 infection. We recommend keeping this high on the differential in SARS-CoV-2-infected patients presenting with acute kidney injury.
    Language English
    Publishing date 2023-02-15
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.35006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Acute PR3-ANCA vasculitis in an asymptomatic COVID-19 teenager.

    Wintler, Taylor / Zherebtsov, Monica / Carmack, Susanne / Muntean, Rebecca / Hill, Sarah J

    Journal of pediatric surgery case reports

    2021  Volume 75, Page(s) 102103

    Abstract: We present the case of an acute onset ANCA positive vasculitis in an asymptomatic COVID-19 infected ... for COVID-19 total IgG/IgM antibodies and ANCA antibodies. This case complements previously reported cases ... of COVID-19 induced autoimmune disease in children but is novel in describing extensive intestinal disease ...

    Abstract We present the case of an acute onset ANCA positive vasculitis in an asymptomatic COVID-19 infected teenager, resulting in significant colonic damage. The patient was initially diagnosed with Henoch-Schönlein purpura and presented with worsening symptoms with significant necrosis of her perineum and rectum requiring surgical debridement and diverting colostomy. As a part of her work-up, she tested positive for COVID-19 total IgG/IgM antibodies and ANCA antibodies. This case complements previously reported cases of COVID-19 induced autoimmune disease in children but is novel in describing extensive intestinal disease as a result of an autoimmune vasculitis in a child.
    Language English
    Publishing date 2021-10-29
    Publishing country Netherlands
    Document type Case Reports
    ZDB-ID 2715451-8
    ISSN 2213-5766
    ISSN 2213-5766
    DOI 10.1016/j.epsc.2021.102103
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: New onset ANCA-associated vasculitis in an adolescent during an acute COVID-19 infection: a case report.

    Reiff, Daniel D / Meyer, Chloe G / Marlin, Brittany / Mannion, Melissa L

    BMC pediatrics

    2021  Volume 21, Issue 1, Page(s) 333

    Abstract: ... diagnosed with COVID-19 pneumonia after presenting with infectious symptoms of fever, cough, congestion, and ... in the setting of acute COVID-19 infection.: Case presentation: A previously healthy adolescent male was ... 19. Further imaging and laboratory workup showed elevated inflammatory markers, negative infectious ...

    Abstract Background: SARS-CoV-2 has been found to be exquisitely adept at triggering autoimmunity and multiple new onset autoimmune diseases have been described as a post-infectious complication of COVID-19 infection in the adult population. Less has been described in the pediatric population, as infections are more likely to be asymptomatic and less severe. This case reports a previously healthy adolescent patient with new onset antineutrophil cytoplasmic autoantibody-associated vasculitis (AAV) diagnosed in the setting of acute COVID-19 infection.
    Case presentation: A previously healthy adolescent male was diagnosed with COVID-19 pneumonia after presenting with infectious symptoms of fever, cough, congestion, and shortness of breath. After worsening of disease, he was found to have pulmonary nodules, atypical for COVID-19. Further imaging and laboratory workup showed elevated inflammatory markers, negative infectious testing, and positive antineutrophil cytoplasmic antibodies (ANCA) diagnostic for AAV. He was treated with pulse dose steroids followed by a prolonged taper and rituximab. Symptoms resolved and laboratory abnormalities improved over time. At six-month follow-up, lesions were much improved, laboratory markers were within normal limits, and patient remained asymptomatic off medications.
    Conclusions: This case is one of the first in the pediatric population to describe new onset AAV presenting with an acute, symptomatic COVID-19 infection. There is increasing evidence for COVID-19 induced autoimmunity in the pediatric population and pediatric care providers should be on high alert for new onset autoimmune disease in children afflicted by COVID-19.
    MeSH term(s) Adolescent ; Adult ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/complications ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/diagnosis ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/drug therapy ; Antibodies, Antineutrophil Cytoplasmic ; COVID-19 ; Child ; Humans ; Infections ; Male ; SARS-CoV-2
    Chemical Substances Antibodies, Antineutrophil Cytoplasmic
    Language English
    Publishing date 2021-08-05
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2041342-7
    ISSN 1471-2431 ; 1471-2431
    ISSN (online) 1471-2431
    ISSN 1471-2431
    DOI 10.1186/s12887-021-02812-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Distinct Autoimmune Antibody Signatures Between Hospitalized Acute COVID-19 Patients, SARS-CoV-2 Convalescent Individuals, and Unexposed Pre-Pandemic Controls

    Bhadelia, Nahid / Belkina, Anna / Olson, Alex / Winter, Thomas / Urick, Patricia / Lin, Nina / Rifkin, Ian / Kataria, Yachana / Yuen, Rachel / Sagar, Manish / Cappione, Jennifer

    medRxiv

    Abstract: ... Proteinase 3-ANCA, anti-Mi-2, anti-Jo-1 and anti-RNP/SM defined acute COVID-19 subjects; and anti-Proteinase 3 ... subjects (7 of 9, 78%) [OR 17.4, 95% CI, 2.0 - 287.4, p = 0.02] and subjects with acute COVID-19 (12 of 20 ... its role in the onset and persistence of post-acute sequelae of COVID-19. ...

    Abstract Abstract Increasing evidence suggests that autoimmunity may play a role in the pathophysiology of SARS-CoV-2 infection during both the acute and "long COVID" phases of disease. However, an assessment of autoimmune antibodies in convalescent SARS-CoV-2 patients has not yet been reported. Methodology: We compared the levels of 18 different IgG autoantibodies (AABs) between four groups: (1) unexposed pre-pandemic subjects from the general population (n = 29); (2) individuals hospitalized with acute moderate to severe COVID-19 (n = 20); (3) convalescent SARS-COV-2-infected subjects with asymptomatic to mild viral symptoms during the acute phase with samples obtained between 1.8 and 7.3 months after infection (n = 9); and (4) unexposed pre-pandemic subjects with systemic lupus erythematous (SLE) (n = 6). Total IgG and IgA levels were also measured from subjects in groups 1-3 to assess non-specific pan-B cell activation. Results: As expected, in multivariate analysis, AABs were detected at much higher odds in SLE subjects (5 of 6, 83%) compared to non-SLE pre-pandemic controls (11 of 29, 38%) [odds ratio (OR) 19.4,95% CI, 2.0 - 557.0, p = 0.03]. AAB detection (percentage of subjects with one or more autoantibodies) was higher in SARS-CoV-2 infected convalescent subjects (7 of 9, 78%) [OR 17.4, 95% CI, 2.0 - 287.4, p = 0.02] and subjects with acute COVID-19 (12 of 20, 60%) compared with non-SLE pre-pandemic controls, but was not statistically significant among the latter [OR 1.8,95% CI, 0.6 - 8.1, p = 0.23]. Within the convalescent subject group, AABs were detected in 5/5 with reported persistent symptoms and 2/4 without continued symptoms (p = 0.17). The multivariate computational algorithm Partial Least Squares Determinant Analysis (PLSDA) was used to determine if distinct AAB signatures distinguish subject groups 1-3. Of the 18 autoantibodies measured, anti-Beta 2-Glycoprotein, anti-Proteinase 3-ANCA, anti-Mi-2 and anti-PM/Scl-100 defined the convalescent group; anti-Proteinase 3-ANCA, anti-Mi-2, anti-Jo-1 and anti-RNP/SM defined acute COVID-19 subjects; and anti-Proteinase 3-ANCA, anti-Mi-2, anti-Jo-1, anti-Beta 2-Glycoprotein distinguished unexposed controls. The AABs defining SARS-COV-2 infected from pre-pandemic subjects are widely associated with myopathies, vasculitis, and antiphospholipid syndromes, conditions with some similarities to COVID-19. Compared to pre-pandemic non-SLE controls, subjects with acute COVID-19 had higher total IgG concentration (p-value=0.006) but convalescent subjects did not (p-value=0.08); no differences in total IgA levels were found between groups. Conclusions: Our findings support existing studies suggesting induction of immune responses to self-epitopes during acute, severe COVID-19 with evidence of general B cell hyperactivation. Also, the preponderance of AAB positivity among convalescent individuals up to seven months after infection indicates potential initiation or proliferation, and then persistence of self-reactive immunity without severe initial disease. These results underscore the importance of further investigation of autoimmunity during SARS-CoV-2 infection and its role in the onset and persistence of post-acute sequelae of COVID-19.
    Keywords covid19
    Language English
    Publishing date 2021-01-25
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2021.01.21.21249176
    Database COVID19

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