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Case Reports
. 2020 Aug 10;12(8):e9643.
doi: 10.7759/cureus.9643.

Anti-Neutrophilic Cytoplasmic Antibody (ANCA) Vasculitis Presented as Pulmonary Hemorrhage in a Positive COVID-19 Patient: A Case Report

Albadr Hussein  1 , Khaled Al Khalil  1 , Yasser M Bawazir  2
Affiliations
Case Reports

Anti-Neutrophilic Cytoplasmic Antibody (ANCA) Vasculitis Presented as Pulmonary Hemorrhage in a Positive COVID-19 Patient: A Case Report

Albadr Hussein et al. Cureus. .

Abstract

Granulomatosis with polyangiitis is a small vessel vasculitis with a wide spectrum of presentation, ranging from limited disease to life-threatening situation such as alveolar hemorrhage. Immunosuppression is the corner stone of the treatment and if left untreated, the death toll increases dramatically. We presented a case of granulomatosis with polyangiitis, presented with alveolar hemorrhage associated with COVID-19 infection. The patient admitted to the intensive care unit, received pulse steroids, plasmapheresis and intravenous immunoglobulin. She was not given further immunosuppression because of the coexisting COVID-19. Up to our knowledge, this is the first reported case of alveolar hemorrhage secondary to granulomatosis with polyangiitis coexisting with COVID-19 infection.

Keywords: alveolar hemorrhage; anca; covid-19; granulomatosis with polyangiitis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Chest X-ray (PA view)
Posteroanterior (PA) view: diffuse bilateral middle and lower zone heterogeneous opacity (Yellow arrows).
Figure 2
Figure 2. CT chest (lung window)
CT chest (lung window) demonstrated a widespread patchy consolidation with central and peripheral distribution, permeated by ground glass areas and crazy paving pattern. These findings are suggestive of diffuse alveolar hemorrhage (blue arrows).
Figure 3
Figure 3. CT chest (Mediastinal window)
The evaluation is limited but there are a few paratracheal lymph nodes (yellow arrow).
See this image and copyright information in PMC

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