Antineutrophil Cytoplasmic Autoantibody (ANCA)-Associated Vasculitis With Mucosal Involvement Following COVID-19 Pneumonia

Antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitides (AAV) are a group of inflammatory disorders in which autoantibodies damage small arteries throughout the body, including in the upper and lower respiratory system, kidneys, as well as the skin. AAV may be precipitated by a variety of causes, including infections. In this report, we examine the case of a patient who developed AAV that was suspected primarily based on mucocutaneous hemorrhagic bullae, elevated ANCA levels, and subsequently confirmed by kidney biopsy, while recovering from coronavirus disease 2019 (COVID-19) infection. AAV and COVID-19 infections may present with similar symptoms, rendering an accurate diagnosis challenging. Additionally, only a few other cases describing a similar onset of AAV post-COVID-19 infection have been described in the literature. Initial presenting features of AAV in such cases have varied considerably, which makes the diagnosis even more challenging. We also engage in a review of such cases to assess key similarities, different treatment options, and outcomes. Lastly, the fact that several mechanisms have been proposed for AAV highlights the need for continued research to help clarify the pathophysiology while also identifying the optimal therapy.