anca相关性血管炎和COVID-19患者免疫抑制治疗后SARS-CoV-2感染复发或再激活

Clinical Nephrology. Case Studies Pub Date : 2022-01-05 eCollection Date: 2022-01-01 DOI:10.5414/CNCS110567
Mansour Mbengue, Bede Bigirimana, Lolly Romeo Irankunda, Mohamed Cherif Dial, Abdou Niang
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引用次数: 0

摘要

。急性肾小管损伤是本病最常见的病变。然而,最近报道了4例anca相关血管炎(AAV)合并COVID-19合并少免疫肾小球肾炎。我们报告了一名70岁的非洲妇女的病例,在COVID-19的背景下,我们诊断了AAV伴少免疫肾小球肾炎。她因COVID-19接受羟氯喹和阿奇霉素治疗。皮质类固醇和环磷酰胺已被用于治疗血管炎。这一演变的标志是在开始免疫抑制治疗一个月后再次出现COVID-19。病人一周后死于呼吸衰竭。在COVID-19期间发生AAV可能不是由于不幸的关联,而是由SARS-CoV-2感染引发的。由于病毒感染再激活或复发的潜在风险,应讨论免疫抑制治疗的使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Recurrence or reactivation of SARS-CoV-2 infection after immunosuppressive therapy in patients with ANCA-associated vasculitis and COVID-19.

. Acute tubular injury is the lesion most frequently described in this disease. However, four cases of ANCA-associated vasculitis (AAV) with COVID-19 with pauci-immune glomerulonephritis have recently been described. We report the case of an African woman, aged 70, in whom we diagnosed an AAV with pauci-immune glomerulonephritis in the context of COVID-19. She was treated with hydroxychloroquine and azithromycin for COVID-19. Corticosteroids and cyclophosphamide have been used for the treatment of vasculitis. The evolution was marked by the reappearance of COVID-19 one month after the beginning of an immunosuppressive therapy. The patient died a week later from respiratory failure. The occurrence of AAV during COVID-19 may not be due an unfortunate association but triggered by infection with SARS-CoV-2. The use of immunosuppressive therapy should be discussed due to the potential risk of reactivation or recurrence of the viral infection.

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