SARS-CoV-2 as a trigger of IgA vasculitis: a clinical case and literature review

Rheumatol Int. 2024 Nov;44(11):2613-2620. doi: 10.1007/s00296-024-05712-3. Epub 2024 Sep 9.

Abstract

Coronavirus Disease 2019 (COVID-19), caused by SARS-CoV-2, has negatively affected global health. COVID-19 has been associated with a variety of autoimmune and inflammatory disorders, complicating its respiratory manifestations. SARS-CoV-2 triggers inflammatory reactions which may involve multiple organs and systems. The proof for IgA involvement in the immune reactions to coronavirus infection is growing, particularly in the case of IgA immune complex deposition diseases such as IgA vasculitis (IgAV) and IgA nephropathy.This report presents a case of IgAV caused by SARS-CoV-2 in a 53-year-old man. His symptoms included papillomatous, bright red rashes, urticaria throughout the body, aphthous stomatitis, pain in all joints and muscles, weakness, malaise, abdominal pain, face swelling, and arterial hypertension (160/100 mmHg). He received intravenous methylprednisolone (250 mg) and then oral methylprednisolone (16 mg) treatment, which improved his condition. This improvement included the disappearance of abdominal and joint pain and skin rashes.This article also provides an overview of published cases of IgAV after SARS-CoV-2. It may alert rheumatologists and allied specialists of clinical features of IgAV and guide them how to diagnose and treat this disease.

Keywords: COVID-19; Coronavirus infection; Henoch-Schonlein purpura; IgA vasculitis; SARS-CoV-2; Vasculitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • COVID-19* / complications
  • COVID-19* / immunology
  • Humans
  • IgA Vasculitis* / diagnosis
  • IgA Vasculitis* / drug therapy
  • IgA Vasculitis* / immunology
  • Immunoglobulin A / immunology
  • Male
  • Methylprednisolone* / therapeutic use
  • Middle Aged
  • SARS-CoV-2* / immunology

Substances

  • Immunoglobulin A
  • Methylprednisolone