Abstract
We describe a case of a 48-year-old woman who presented with acute respiratory failure due to diffuse alveolar haemorrhage and acute renal failure due to pauci-immune glomerulonephritis consistent with a new diagnosis of microscopic polyangiitis (MPA). The patient had a recent SARS-CoV-2 infection 6 weeks before MPA diagnosis and had stopped immunosuppression for her rheumatoid arthritis (RA) at that time. The patient was treated with pulse intravenous steroids, plasma exchange therapy and rituximab, which induced remission of her illness. This case highlights a timely dilemma of holding immunosuppression in a RA patient with low disease activity on combination therapy with SARS-CoV-2 infection, and the potential risk of developing an additional autoimmune disease, such as vasculitis, given their existing autoimmunity due to RA.
Keywords: COVID-19; acute renal failure; biological agents; rheumatoid arthritis; vasculitis.
【저자키워드】 COVID-19, rheumatoid arthritis, Vasculitis, acute renal failure, Biological agents, 【초록키워드】 Autoimmunity, therapy, Respiratory failure, SARS-COV-2 infection, Diagnosis, Immunosuppression, combination therapy, Steroids, Autoimmune disease, Patient, plasma, Vasculitis, Disease activity, intravenous, potential risk, renal, pulse, alveolar, highlight, treated, 【제목키워드】 SARS-COV-2 infection, Immunosuppression, risk, Withdrawal, rheumatoid arthritis,