Development of ANCA-associated vasculitis after COVID-19 in a patient with Lynch syndrome and atypical hemolytic uremic syndrome

Abstract

COVID-19 can be asymptomatic or cause very serious clinical pictures that can affect multiple systems. As the disease progresses, our clinical experience and the clinical presentations and management strategies we encounter also become more diverse and distinct. Anti Neutrophil Cytoplasmic Antibody (ANCA) positivity is particularly used as an indicator in the diagnosis of small vessel vasculitis such as granulomatous polyangitis, microscopic poliarteritis nodosa (m-PAN), and eosinophilic granulomatous polyangiitis (eGPA). ANCA-associated vasculitis can present with severe respiratory symptoms. Management of this group of patients is very difficult because COVID -19 pneumonia can very often be mistaken for these complaints and leads to serious limitations in the immunosuppressive treatment that should be used in the management of ANCA-associated vasculitis. At the beginning of the epidemic, our knowledge was limited by the increased susceptibility to infections and more severe disease in patients receiving immunosuppressive therapy for the combination of COVID -19 and vasculitic syndromes, whereas subsequently vasculitis cases were reported secondary to infections. In our case, the diagnoses of atypical hemolytic uremic syndrome (A-HUS) and Lynch syndrome were made, and the diagnosis of vasculitis due to new-onset ANCA positivity and alveolar hemorrhage after COVID -19 pneumonia was successfully treated with immunosuppressants.

Keywords

• covid-19
• anca i̇lişkili vaskülit
• atipik-hus
• lynch sendromu
• covid-19
• anca-associated vasculitis
• lynch syndrome