tetano
Editor, Senior Moderator
J Rheumatol
. 2022 Sep 1;jrheum.220503.
doi: 10.3899/jrheum.220503. Online ahead of print.
Immunoglobulin A Vasculitis Following COVID-19: A French Multicenter Case Series
Yanis Ramdani[SUP] 1 [/SUP], Jean Marc Galempoix[SUP] 1 [/SUP], Jean François Augusto[SUP] 1 [/SUP], Eva Dekmeer[SUP] 1 [/SUP], Laurent Perard[SUP] 1 [/SUP], Nicole Ferreira[SUP] 1 [/SUP], Adrien Bigot[SUP] 1 [/SUP], Julie Magnant[SUP] 1 [/SUP], Stéphanie Jobard[SUP] 1 [/SUP], Elisabeth Diot[SUP] 1 [/SUP], Marie Charlotte Besse[SUP] 1 [/SUP], Hélène Henrique[SUP] 1 [/SUP], François Maillot[SUP] 1 [/SUP], Alexandra Audemard-Verger[SUP] 1 [/SUP]
Affiliations
Abstract
Objective: Immunoglobulin A vasculitis (IgAV) usually occurs following viral respiratory tract infection. In the context of the global coronavirus disease 2019 (COVID-19) pandemic, we describe a case series of patients who developed IgAV following SARS-CoV-2 infection.
Methods: This national multicenter retrospective study included patients with IgAV following SARS-CoV-2 infection from January 1, 2020, to January 1, 2022. Patients had histologically proven IgAV and reverse transcription PCR (RT-PCR)-proven SARS-CoV-2 infection. The interval between infection and vasculitis onset had to be < 4 weeks.
Results: We included 5 patients, 4 of whom were women with a mean age of 45 years. Four patients had paucisymptomatic infections and 1 required a 48-hour low-flow oxygen treatment. All 5 patients had purpuric skin involvement. Arthritis was observed in 2 patients, 3 had IgA glomerulonephritis, and 2 had digestive involvement. Three renal biopsies were performed and showed mesangial IgA deposits without any extracapillary proliferation. Median C-reactive protein was 180 (range 15.1-225) mg/L, median serum creatinine level was 65 (range 41-169) μmol/L, and 2 patients had a glomerular filtration rate < 60 mL/min. Four patients received first-line treatment with glucocorticoids. All patients had a favorable progression and 2 patients experienced minor skin relapses, one after COVID-19 vaccination.
Conclusion: This series describes the emergence of IgAV closely following COVID-19; we were not able to eliminate an incidental link between these events. Their disease outcomes were favorable. In most of our patients, the SARS-CoV-2 infection was paucisymptomatic, and we recommend RT-PCR tests to look for COVID-19 in patients without any evident triggers for IgAV.
. 2022 Sep 1;jrheum.220503.
doi: 10.3899/jrheum.220503. Online ahead of print.
Immunoglobulin A Vasculitis Following COVID-19: A French Multicenter Case Series
Yanis Ramdani[SUP] 1 [/SUP], Jean Marc Galempoix[SUP] 1 [/SUP], Jean François Augusto[SUP] 1 [/SUP], Eva Dekmeer[SUP] 1 [/SUP], Laurent Perard[SUP] 1 [/SUP], Nicole Ferreira[SUP] 1 [/SUP], Adrien Bigot[SUP] 1 [/SUP], Julie Magnant[SUP] 1 [/SUP], Stéphanie Jobard[SUP] 1 [/SUP], Elisabeth Diot[SUP] 1 [/SUP], Marie Charlotte Besse[SUP] 1 [/SUP], Hélène Henrique[SUP] 1 [/SUP], François Maillot[SUP] 1 [/SUP], Alexandra Audemard-Verger[SUP] 1 [/SUP]
Affiliations
- PMID: 36243405
- DOI: 10.3899/jrheum.220503
Abstract
Objective: Immunoglobulin A vasculitis (IgAV) usually occurs following viral respiratory tract infection. In the context of the global coronavirus disease 2019 (COVID-19) pandemic, we describe a case series of patients who developed IgAV following SARS-CoV-2 infection.
Methods: This national multicenter retrospective study included patients with IgAV following SARS-CoV-2 infection from January 1, 2020, to January 1, 2022. Patients had histologically proven IgAV and reverse transcription PCR (RT-PCR)-proven SARS-CoV-2 infection. The interval between infection and vasculitis onset had to be < 4 weeks.
Results: We included 5 patients, 4 of whom were women with a mean age of 45 years. Four patients had paucisymptomatic infections and 1 required a 48-hour low-flow oxygen treatment. All 5 patients had purpuric skin involvement. Arthritis was observed in 2 patients, 3 had IgA glomerulonephritis, and 2 had digestive involvement. Three renal biopsies were performed and showed mesangial IgA deposits without any extracapillary proliferation. Median C-reactive protein was 180 (range 15.1-225) mg/L, median serum creatinine level was 65 (range 41-169) μmol/L, and 2 patients had a glomerular filtration rate < 60 mL/min. Four patients received first-line treatment with glucocorticoids. All patients had a favorable progression and 2 patients experienced minor skin relapses, one after COVID-19 vaccination.
Conclusion: This series describes the emergence of IgAV closely following COVID-19; we were not able to eliminate an incidental link between these events. Their disease outcomes were favorable. In most of our patients, the SARS-CoV-2 infection was paucisymptomatic, and we recommend RT-PCR tests to look for COVID-19 in patients without any evident triggers for IgAV.