A case of microscopic polyangiitis with interstitial pneumonia after coronavirus disease-2019 infection, evidenced by positivity for multiple autoantibodies

IF 0.8 Q4 RESPIRATORY SYSTEM

Respiratory Medicine Case Reports Pub Date : 2024-01-01 DOI:10.1016/j.rmcr.2024.102103

Naoto Arai , Toshikazu Takasaki , Masashi Bando , Kei Yaoita , Yutaro Ueki , Shu Hisata , Makoto Maemondo

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Abstract

Anti-neutrophil cytoplasmic antibody-associated vasculitis is triggered by infection, dust exposure, and drugs. A 73-year-old male presented with dyspnea. Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection was confirmed upon admission. Exacerbation of interstitial pneumonia and renal dysfunction were observed. Analysis revealed positivity for myeloperoxidase-anti-neutrophil cytoplasmic antibody, other anti-aminoacyl transfer RNA synthetase antibodies, and anti-melanoma differentiation-associated gene 5. Renal biopsy confirmed crescentic glomerulonephritis, leading to the diagnosis of microscopic polyangiitis. Combination therapy with prednisolone and cyclophosphamide was initiated, resulting in improved respiratory and renal failure. There is a potential association between SARS-CoV-2 infection and the onset of autoimmune diseases.

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一例感染冠状病毒病-2019 后伴有间质性肺炎的显微镜下多血管炎病例，多种自身抗体阳性是其证据

抗中性粒细胞胞浆抗体相关性血管炎是由感染、接触粉尘和药物引发的。一名 73 岁的男性出现呼吸困难。入院时确诊感染了严重急性呼吸系统综合征-冠状病毒 2（SARS-CoV-2）。观察到间质性肺炎加重和肾功能障碍。分析显示，髓过氧化物酶-抗中性粒细胞胞浆抗体、其他抗氨基酸转移 RNA 合成酶抗体和抗黑色素瘤分化相关基因 5 呈阳性。肾活检证实了新月体性肾小球肾炎，诊断为显微镜下多血管炎。开始使用泼尼松龙和环磷酰胺联合治疗，结果呼吸衰竭和肾衰竭得到改善。SARS-CoV-2 感染与自身免疫性疾病的发病之间可能存在关联。

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