新发的微观多炎暂时与严重的COVID-19感染相关:一个病例报告
José A Meade-Aguilar1, Yessica N Varela-Martinez2, Sandra P Ramirez-Eguía2
1Department of Internal Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
SAGE open medical case reports
|July 12, 2023
概括
冠状病毒疾病2019可以引发像微观多炎这样的免疫媒介疾病. 这一案例凸显了在患有严重COVID-19症状和快速器官衰退的患者中考虑自身免疫性疾病 (如血管炎) 的重要性.
科学领域:
- 免疫学 免疫学 免疫学
- 腎臟病學 (nephrology) 是一種醫學.
- 类风湿病学 类风湿病学
背景情况:
- 冠状病毒疾病2019 (COVID-19) 越来越多地被认为是各种免疫媒介疾病的触发因素.
- 抗中性细胞质抗体相关的血管炎是一种罕见的自身免疫性疾病,影响小血管,导致组织损伤.
研究的目的:
- 为了呈现一种与COVID-19感染暂时相关的微观多炎病例.
- 进行关于COVID-19作为血管炎的触发因素的文献综述.
主要方法:
- 一个66岁的女性患有发烧,,咳,呼吸障碍和血的症状.
- 诊断工作包括胸部CT,血液分析,尿液沉积物,支气管镜检查,p-ANCA的免疫光,抗MPO水平和脏活检.
- 治疗包括脉冲剂量类固醇和环胺.
主要成果:
- 这位患者出现了扩散的膜出血和急性损伤.
- 诊断测试证实了微观多炎,具有阳性p-ANCA和抗MPO抗体,以及在活检上发现的免疫性焦点和细分瘤硬化.
- 这种情况被诊断为由SARS-CoV-2感染引发的微观多炎.
结论:
- COVID-19可以引发像微观多管炎这样的自身免疫性疾病,即使在没有先前自身免疫病史的患者中也是如此.
- 在COVID-19患者中,非典型的肺部发现和功能快速下降应该引起有关血管炎的怀疑.
- 及时诊断和治疗对于防止不可逆转的末端器官损伤至关重要.
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