Did COVID-19 benefit a patient with microscopic polyangiitis?
Abstract
Microscopic polyangiitis (MPA) is a necrotizing inflammation that affects almost exclusively small vessels, i.e. capillaries, arterioles and venules. It manifests most often in individuals aged 50–60. It is a systemic disease that most commonly involves the kidneys and lungs. Rapidly progressive glomerulonephritis is the most important clinical presentation of the disease. It affects 80–100% of patients and most often leads to renal failure. The diagnosis of MPA is based on the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) 2022 classification criteria.
Nasal involvement in the form of bloody nasal discharge, nasal crusting or sino-nasal congestion, blockage, damage or perforation of the nasal septum are clinical criteria and refute the diagnosis of MPA (–3).
Laboratory criteria are the perinuclear antineutrophil cytoplasmic antibody (pANCA) or anti–myeloperoxidase-ANCA (MPO-ANCA) positivity (6), cytoplasmic ANCA (cANCA) or anti–proteinase 3 ANCA (PR3-ANCA) positivity (–1), eosinophil count ≥ 1000/µL (–4); imaging criteria are lung fibrosis or interstitial lung disease (3), and pauci-immune glomerulonephritis represents histological criteria (3).
A score ≥ 5 in six categories is required to meet the classification criteria.
Keywords: microscopic polyangiitistocilizumabCOVID-19
References
- Geraldes R, Santos M, Ponte C, et al. DCVAS Study Group, DCVAS Study Group, DCVAS Study Group, DCVAS Study Group, DCVAS Study Group, DCVAS Study Group, DCVAS Study Group, DCVAS Investigators, DCVAS INVESTIGATORS, DCVAS Study Group, DCVAS Study Group, DCVAS Study Group. Are the 1990 American College of Rheumatology vasculitis classification criteria still valid? Rheumatology (Oxford). 2017; 56(7): 1154–1161.
- Kallenberg CGM. The diagnosis and classification of microscopic polyangiitis. J Autoimmun. 2014; 48-49: 90–93.
- Zimmermann-Górska I. Terapia w chorobach reumatycznych. Wydawnictwo Lekarskie PZWL, Warszawa 2018: 226–227.
- Chung SA, Seo P. Microscopic polyangiitis. Rheum Dis Clin North Am. 2010; 36(3): 545–558.
- Schirmer JH, Sanchez-Alamo B, Hellmich B, et al. EULAR recommendations for the management of ANCA-associated vasculitis: 2022 update. Ann Rheum Dis. 2024; 83(1): 30–47.
- Harigai M, Tsutsumino M, Takada H, et al. Molecular targeted therapies for microscopic polyangiitis and granulomatosis with polyangiitis. Korean J Intern Med. 2019; 34(3): 492–503.
