Loukas Kakoullis1, Konstantinos Parperis2, Eleni Papachristodoulou3, George Panos4. 1. Department of Respiratory Medicine, University of Patras General Hospital, Patras, Greece; Department of Internal Medicine, University of Cyprus Medical School, Nicosia, Cyprus. 2. Department of Medicine, Division of Rheumatology, University of Arizona College of Medicine, Phoenix, AZ, USA; Department of Internal Medicine, Division of Rheumatology, University of Cyprus Medical School, Nicosia, Cyprus. 3. Department of Internal Medicine, Division of Rheumatology, University of Cyprus Medical School, Nicosia, Cyprus. 4. Department of Internal Medicine, University of Cyprus Medical School, Nicosia, Cyprus; Department of Internal Medicine, Section of Infectious Diseases, University of Patras General Hospital, Patras, Greece. Electronic address: george.panos.frcp@gmail.com.
Abstract
BACKGROUND: We conducted a systematic review to identify cases of infection-induced anti-myeloperoxidase (MPO) antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). METHODS: PubMed/Medline databases were searched from inception to July of 2020, according to PRISMA guidelines. RESULTS: Among the 618 abstracts identified, 18 articles describing 23 patients (60.9% female, mean age 50.5 years) were included. Median time between infection and vasculitis development was 3 months. Five (21.7%) patients expired during follow-up. Vasculitis regressed after the resolution of infection in 12/23 (52.2%). ANCA titers decreased significantly on follow-up in 14/16 patients and in all survivors in which they were measured. Pathogens reported included Mycobacterium spp., Coccidioides spp., Rickettsia rickettsii, Staphylococcus spp., EBV, CMV and Dengue virus. CONCLUSIONS: MPO-AAV can occur after infection and may regress after its resolution. Infection should be considered in cases of MPO-AAV, as immunosuppressive treatment can have catastrophic results if the infection is not adequately treated.
BACKGROUND: We conducted a systematic review to identify cases of infection-induced anti-myeloperoxidase (MPO) antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). METHODS: PubMed/Medline databases were searched from inception to July of 2020, according to PRISMA guidelines. RESULTS: Among the 618 abstracts identified, 18 articles describing 23 patients (60.9% female, mean age 50.5 years) were included. Median time between infection and vasculitis development was 3 months. Five (21.7%) patients expired during follow-up. Vasculitis regressed after the resolution of infection in 12/23 (52.2%). ANCA titers decreased significantly on follow-up in 14/16 patients and in all survivors in which they were measured. Pathogens reported included Mycobacterium spp., Coccidioides spp., Rickettsia rickettsii, Staphylococcus spp., EBV, CMV and Dengue virus. CONCLUSIONS:MPO-AAV can occur after infection and may regress after its resolution. Infection should be considered in cases of MPO-AAV, as immunosuppressive treatment can have catastrophic results if the infection is not adequately treated.
Authors: Hana Flogelova; Eva Karaskova; Katerina Bouchalova; Marie Rohanova; Vendula Latalova; Tomas Tichy; Vladimir Tesar Journal: Case Rep Nephrol Dial Date: 2022-03-14