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Case Reports
. 2021 Oct;56(10):3422-3424.
doi: 10.1002/ppul.25612. Epub 2021 Aug 11.

Pediatric P-ANCA vasculitis following COVID-19

Yaron Fireizen  1   2 , Cyrus Shahriary  1   2 , Maria E Imperial  1   2 , Inderpal Randhawa  1   2 , Nastasia Nianiaris  1   2 , Bugsu Ovunc  1   2
Affiliations
Case Reports

Pediatric P-ANCA vasculitis following COVID-19

Yaron Fireizen et al. Pediatr Pulmonol. 2021 Oct.

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.

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Conflict of interest statement

The authors declare that there are no conflict of interests.

Figures

Figure 1
Figure 1
CT angiography noting extensive heterogeneous infiltrates in both lungs with an unusual fluffy central distribution concerning for diffuse alveolar hemorrhage
See this image and copyright information in PMC

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