Association of COVID‐19 antigenicity with the development of antineutrophilic cytoplasmic antibody vasculitis

Abstract

Inflammatory processes, such as an infection or drug reaction, can cause antineutrophil cytoplasmic autoantibody (ANCA)‐associated vasculitis (AAV). Although quite rare, AAV may occur with SARS‐coronavirus disease 2019 (COVID‐19) antigenic exposure, either from infection or immunization. We present two cases of AAV: one that developed after COVID‐19 infection presenting as diffuse alveolar haemorrhage and another that developed shortly after vaccination, presenting as granulomatous pulmonary nodules. Both patients improved with supportive care and immunosuppressive therapies. This adverse event appears to be a very rare complication of COVID‐19 infection or vaccination. Early diagnosis of AAV is important because immunosuppressive therapy may improve patient outcomes.

New‐onset ANCA‐associated vasculitis presenting with neuropathy after COVID‐19 infection: A case report and literature review

“…These reactions are responsible for most of the symptoms of an induced autoimmune disease after COVID-19 infection. 15,16 There can be other mechanisms besides vasculitis that can justify the neurological presentations. COVID-19 has been associated with vascular issues, including blood clot formation.…”

“…It activates the inflammatory cascade and causes tissue destruction and organ failure. These reactions are responsible for most of the symptoms of an induced autoimmune disease after COVID‐19 infection 15,16 …”

End stage renal disease in patient with microscopic polyangiitis and atypical hemolytic-uremic syndrome arose 3 weeks after the third dose of anti-SARS-CoV2 vaccine mRNA-1273: A case report with literature revision

“…Interestingly, isolated case reports described the occurrence of renal TMA in AAV patients, an association that may pose diagnostic and therapeutic challenges. [25–31] In addition, some cases of both de novo and relapses of AAV and/or TMAs after anti-SARS-CoV2 vaccination have been reported [32–53]…”

Increased induction of de novo serum ANCA and ANCA-associated vasculitis after mass vaccination against SARS-CoV-2

“…ANCA-associated vasculitis (AAV) is characterized by the development of autoantibodies against antigens in cytoplasmic granules of neutrophils affecting predominantly to small vessels, with myeloperoxidase (MPO) or proteinase 3 (PR3) being the main antigens toward which these autoantibodies are directed. Although the development of ANCA after influenza vaccination has been previously reported, most of the studies that analyze the possible relationship between SARS-CoV-2 vaccination and the development of ANCA and AAV correspond to case reports (Chen et al, 2021;Davidovic et al, 2021;Dube et al, 2021;Feghali et al, 2021;Felzer et al, 2021;Hakroush and Tampe, 2021;Okuda et al, 2021). Likewise, the few published works that include series of patients and review the temporal association between glomerular disease and SARS-CoV-2 vaccination only include very few cases of AAV, as these studies consider the effect of the vaccine on the development of different types of glomerulonephritis, such as immunoglobulin A (IgA) nephropathy, membranous nephropathy, minimal change disease, collapsing glomerulopathy, or lupus nephritis (Caza et al, 2021;Fenoglio et al, 2022;Klomjit et al, 2021).…”