A case of granulomatosis of polyangiitis presenting with COVID-19 infection: False-positivity or co-existence?

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Marmara Medical Journal Pub Date : 2023-09-29 DOI:10.5472/marumj.1368360
Ibrahim Gökce, Mehtap Sak, Sercin Guven, Serim Pul, Harika Alpay
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 COVID-19 presents with non-specific symptoms of the upper airway and pulmonary system, which can overlap with other diseases
 involving the respiratory system as granulomatosis with polyangiitis (GPA). Both diseases have high morbidity and mortality rates
 and it is important to promptly differentiate and treat them. Real-time reverse transcriptase polymerase chain reaction (RT-PCR)
 is currently the recommended method for diagnosing COVID-19. Antibody-based tests are used to diagnose both pat and current
 COVID-19 infections.
 We present a previously healthy thirteen-year-old girl who was admitted with upper airway symptoms and pulmonary involvement,
 and progressed to acute kidney failure. Laboratory findings showed leukocytosis, anemia, elevated kidney function tests and 2+
 proteinuria. Computed tomography (CT) of the lungs showed multiple nodules, cavities, and ground-glass opacities (GGOs). We
 performed RT-PCR tests for COVID-19 for three times. Results were all negative, but the COVID-19 immunoglobulin (Ig)M test
 sent simultaneously was positive. Based on the cytoplasmic antineutrophilic cytoplasmic antibody (c-ANCA) positivity, upper airway,
 pulmonary, and renal involvement, she was diagnosed as GPA.
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Abstract

Coronavirus disease 2019 (COVID-19) was declared a global pandemic and a public health emergency worldwide in March 2020. COVID-19 presents with non-specific symptoms of the upper airway and pulmonary system, which can overlap with other diseases involving the respiratory system as granulomatosis with polyangiitis (GPA). Both diseases have high morbidity and mortality rates and it is important to promptly differentiate and treat them. Real-time reverse transcriptase polymerase chain reaction (RT-PCR) is currently the recommended method for diagnosing COVID-19. Antibody-based tests are used to diagnose both pat and current COVID-19 infections. We present a previously healthy thirteen-year-old girl who was admitted with upper airway symptoms and pulmonary involvement, and progressed to acute kidney failure. Laboratory findings showed leukocytosis, anemia, elevated kidney function tests and 2+ proteinuria. Computed tomography (CT) of the lungs showed multiple nodules, cavities, and ground-glass opacities (GGOs). We performed RT-PCR tests for COVID-19 for three times. Results were all negative, but the COVID-19 immunoglobulin (Ig)M test sent simultaneously was positive. Based on the cytoplasmic antineutrophilic cytoplasmic antibody (c-ANCA) positivity, upper airway, pulmonary, and renal involvement, she was diagnosed as GPA. This report highlights that COVID-19 antibody tests can be false-positive in patients with autoimmune diseases including GPA.
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多血管炎肉芽肿病合并COVID-19感染1例:假阳性还是共存?
2019年冠状病毒病(COVID-19)于2020年3月被宣布为全球大流行和突发公共卫生事件。COVID-19表现为上呼吸道和肺系统的非特异性症状,可与其他疾病重叠 累及呼吸系统的肉芽肿伴多血管炎(GPA)。这两种疾病的发病率和死亡率都很高 及时鉴别和治疗是非常重要的。实时逆转录聚合酶链反应(RT-PCR) 是目前推荐的新冠肺炎诊断方法。基于抗体的测试用于诊断局部和电流 COVID-19感染强生# x0D;我们报告了一位先前健康的13岁女孩,她因上呼吸道症状和肺部受累而入院, 并发展成急性肾衰竭。实验室结果显示白细胞增多、贫血、肾功能升高和2+ 蛋白尿。肺部计算机断层扫描(CT)显示多发结节、空腔和磨玻璃影(GGOs)。我们# x0D;进行了3次新冠病毒RT-PCR检测。结果均为阴性,但COVID-19免疫球蛋白(Ig)M试验 同时发送是积极的。基于胞浆抗中性粒细胞胞浆抗体(c-ANCA)阳性,上呼吸道, 肺部和肾脏受累,诊断为GPA。 该报告强调,在包括GPA在内的自身免疫性疾病患者中,COVID-19抗体检测可能出现假阳性。
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Marmara Medical Journal
Marmara Medical Journal MEDICINE, GENERAL & INTERNAL-
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期刊介绍: Marmara Medical Journal, Marmara Üniversitesi Tıp Fakültesi tarafından yılda üç kere yayımlanan multidisipliner bir dergidir. Bu dergide tıbbın tüm alanlarına ait orijinal araştırma makaleleri, olgu sunumları ve derlemeler İngilizce veya Türkçe olarak yer alır.
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