Abstract
Background: Perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCA) are associated with a multisystem vasculitis affecting small blood vessels in the body. A handful of adult patients who developed vasculitis post-COVID-19 have been reported. Although SARS-CoV-2 has been shown to drive an exaggerated immune response in the pediatric population, such as in Multisystem Inflammatory Syndrome in Children (MIS-C), only one case of vasculitis following COVID-19 has been reported previously in children.
Case presentation: Seventeen-year-old male with a past medical history of COVID-19 pneumonia two months prior presented with acute kidney injury and diffuse alveolar hemorrhage. Rheumatologic workup revealed P-ANCA and Myeloperoxidase (MPO) positivity. Kidney biopsy showed necrotizing glomerulonephritis with limited immune complex deposition. Subsequently, he was treated with steroids and plasmapheresis, and ultimately started on cyclophosphamide.
Conclusions: To our knowledge, this report presents the second reported pediatric case of P-ANCA/MPO vasculitis following COVID-19.
Keywords: COVID-19; P-ANCA vasculitis; diffuse alveolar hemorrhage.
【저자키워드】 COVID-19, P-ANCA vasculitis, diffuse alveolar hemorrhage, 【초록키워드】 SARS-CoV-2, COVID-19 pneumonia, Pneumonia, antibody, knowledge, pediatric, children, MPO, Acute kidney injury, Steroids, MIS-C, immune complex, Glomerulonephritis, blood vessels, male, Patient, Vasculitis, Plasmapheresis, myeloperoxidase, hemorrhage, steroid, Cyclophosphamide, medical history, Adult patients, past medical history, alveolar, exaggerated immune response, small blood vessels, p-ANCA, shown, reported, treated, cytoplasmic, affecting, Perinuclear, small blood vessel,