Positive Anti-SSA/Ro Antibody in a Woman with SARS-CoV-2 Infection Using Immunophenotyping: A Case Report

Huang, Po-I; Lin, Ting-Chun; Liu, Feng‐Cheng; Ho, Yi‐Jung; Lu, Jeng‐Wei; Lin, Te‐Yu

doi:10.3390/medicina56100521

Cited by 7 publications

(6 citation statements)

References 14 publications

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“…A vasculitis is defined as secondary when blood vessel inflammation is a result of underlying disease or exposure to medications and/or infections like hepatitis B and tuberculosis [ 2 ]. Recent studies have shown that the novel coronavirus disease (COVID-19) has the potential to induce secondary vasculitis in patients [ 3 , 4 ]. Pathogenesis surrounding COVID-19-induced secondary vasculitis is still uncertain, however some researchers have hypothesized a cross-reactivity between SARS-CoV-2 antigen and autoantibodies in autoimmune disease [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

A Rare Case of SARS-CoV-2-Induced Microscopic Polyangiitis

Allena¹,

Patel²,

Nader³

et al. 2021

Cureus

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection triggers elevated levels of circulating cytokines and immune-cell hyperactivation, called a cytokine storm, which leads to dysregulated immune response not only towards the pathogen itself but also contributes to cellular, vascular injury and multiorgan dysfunction. The cytokine-induced endothelial inflammation and vascular pathology of COVID-19 is well reported in post-mortem biopsies and several cases reporting small, medium and large vessel micro/macro thrombotic events and vasculitis in multiple organs. So far, few cases have been reported with newly diagnosed antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis at the time of acute COVID-19 infection. The exact pathophysiology of SARS-CoV-2 and ANCA-associated vasculitis continues to be studied and reviewed. Here we report a case of a 60-year-old female who presented to our institution with sudden onset of shortness of breath and hemoptysis. A detailed history revealed a recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Labs showed elevated serum creatinine, urine analysis with large blood and nephrotic range proteinuria. CT chest was remarkable for abnormal appearance of the parenchyma bilaterally compatible with a crazy paving pattern, suggesting pulmonary alveolar proteinosis versus diffuse alveolar hemorrhage. Vasculitis was suspected and the patient was started on IV corticosteroids and plasmapheresis. Diagnostic workup was positive for antineutrophil cytoplasmic antibodies-myeloperoxidase (ANCA-MPO), anti-Sjögren's syndrome-related antigen A autoantibodies (anti-SS-A) and antinuclear antibodies (ANA). Renal biopsy confirmed focal segmental necrotizing, crescentic and sclerosing glomerulonephritis, pauci-immune type, anti-MPO antibody/P-ANCA associated. A diagnosis of microscopic polyangiitis was made and she was started on rituximab immunosuppressive therapy following which she showed clinical improvement. In this document, we present a unique case of microscopic polyangiitis possibly induced by SARS-CoV-2 infection confirmed by renal biopsy and clinical presentation. In the current setting of a global pandemic, we strongly recommend that vasculitis be high on the differential diagnosis in patients who are currently infected or had been infected with SARS-CoV-2 and present with acute kidney injury (AKI).

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Section: Introductionmentioning

confidence: 99%

A Rare Case of SARS-CoV-2-Induced Microscopic Polyangiitis

Allena¹,

Patel²,

Nader³

et al. 2021

Cureus

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“…COVID -19 is an infectious disease with a strong inflammatory response as demonstrated by the phenomenon of “cytokines storm” [ 7 ]; therefore, it is intriguing to speculate that the reports on positive SSA antibodies in these patients [ 8 , 9 ] may indicate the existence of autoimmune inflammatory response similar to the one described in Sjogren’s syndrome [ 10 , 11 ] that can result in dry mouth as well.…”

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confidence: 99%

Prevalence of dry mouth in COVID-19 patients with and without Sicca syndrome in a large hospital center

Katz

2021

Ir J Med Sci

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“…Además, cabe mencionar la positividad de los autoanticuerpos antinucleares extraíbles de tipo SSA (anti-Ro60). La elevación de los niveles de autoanticuerpos anti-Ro se ha descrito tras la infección por el SARS-CoV-2 [ 2 , 3 ]. Adicionalmente, se ha detallado el aumento de los valores de diferentes marcadores de autoinmunidad (factor reumatoide, anticuerpos anti-Ro y anticuerpos anti-SSB) tras la infección por el SARS-CoV-2 en pacientes afectos de enfermedades reumatológicas [ 4 ].…”

Section: Discussionunclassified

Síndrome de Guillain-Barré y trombocitopenia tras la vacunación contra el SARS-CoV-2 con Moderna. Descripción de un caso

Lázaro¹,

Llauradó²,

Sánchez-Tejerina³

et al. 2022

RevNeurol

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Introducción. La vacunación masiva contra el virus SARS-CoV-2 constituye una de las principales estrategias en la reducción de la morbimortalidad que presenta dicho virus. No obstante, a lo largo de los últimos meses, su administración también se ha relacionado con diversos efectos adversos raros, pero potencialmente graves. Caso clínico. En el presente artículo describimos el caso de un paciente que desarrolló un síndrome de Guillain-Barré y una púrpura trombocitopénica idiopática nueve días después de la vacunación con la tercera dosis contra el virus SARS-CoV-2 (Moderna), con dos dosis previas de AstraZeneca. Adicionalmente, destaca la presencia de positividad para autoanticuerpos anti-SSA/Ro60 y para anticuerpos inmunoglobulina G anti-GM1 e inmunoglobulina G anti-GM3. Conclusión. Aunque no es posible establecer una relación de causalidad entre la administración del booster de la vacuna y el desarrollo de la enfermedad, es destacable la asociación de dos procesos autoinmunes concomitantes, junto con la positividad en los autoanticuerpos anti-SSA/Ro60, lo cual se ha descrito en la bibliografía en casos de infección del virus SARS-CoV-2.

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Positive Anti-SSA/Ro Antibody in a Woman with SARS-CoV-2 Infection Using Immunophenotyping: A Case Report

Cited by 7 publications

References 14 publications

A Rare Case of SARS-CoV-2-Induced Microscopic Polyangiitis

A Rare Case of SARS-CoV-2-Induced Microscopic Polyangiitis

Prevalence of dry mouth in COVID-19 patients with and without Sicca syndrome in a large hospital center

Síndrome de Guillain-Barré y trombocitopenia tras la vacunación contra el SARS-CoV-2 con Moderna. Descripción de un caso

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