Acute PR3-ANCA vasculitis in an asymptomatic COVID-19 teenager

Taylor Wintler; Monica Zherebtsov; Susanne Carmack; Rebecca Muntean; Sarah J Hill

doi:10.1016/j.epsc.2021.102103

Acute PR3-ANCA vasculitis in an asymptomatic COVID-19 teenager

J Pediatr Surg Case Rep. 2021 Dec:75:102103. doi: 10.1016/j.epsc.2021.102103. Epub 2021 Oct 29.

Authors

Taylor Wintler¹, Monica Zherebtsov², Susanne Carmack³, Rebecca Muntean⁴, Sarah J Hill⁵

Affiliations

¹ Washington State University, Elson S. Floyd College of Medicine, Spokane, WA, USA.
² Pediatric Gastroenterology Providence Digestive Health Institute, Spokane, WA, USA.
³ Incyte Diagnostics, Spokane, WA, USA.
⁴ Providence Rheumatology Providence Health and Services, Spokane, WA, USA.
⁵ Providence Sacred Heart Medical Center Pediatric Surgery, Spokane, WA, USA.

Abstract

We present the case of an acute onset ANCA positive vasculitis in an asymptomatic COVID-19 infected teenager, resulting in significant colonic damage. The patient was initially diagnosed with Henoch-Schönlein purpura and presented with worsening symptoms with significant necrosis of her perineum and rectum requiring surgical debridement and diverting colostomy. As a part of her work-up, she tested positive for COVID-19 total IgG/IgM antibodies and ANCA antibodies. This case complements previously reported cases of COVID-19 induced autoimmune disease in children but is novel in describing extensive intestinal disease as a result of an autoimmune vasculitis in a child.

Keywords: ANA, anti-nuclear antibody; ANCA; ANCA, antineutrophil cytoplasmic antibody; CMV, Cytomegalovirus; COVID-19; COVID-19, coronavirus disease 2019; EBV, Epstein-Barr virus; HSP, Henoch Schönlein Purpura; Henoch Schonlein purpura; IgG, immunoglobulin G; MIS-C, multisystem inflammatory syndrome in children; NSAIDs, Non-steroidal anti-inflammatory drugs; Vasculitis; anti-MPO, myeloperoxidase antibody; anti-PR3, proteinase 3 antibody.

Publication types

Case Reports