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Pediatric P-ANCA Vasculitis following COVID-19
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  • Yaron Fireizen,
  • Cyrus Shahriary,
  • Maria Imperial,
  • Inderpal Randhawa,
  • Nastasia Nianiaris,
  • Bugsu Ovunc
Yaron Fireizen
Miller Children's and Women's Hospital Long Beach
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Cyrus Shahriary
Miller Children's and Women's Hospital Long Beach
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Maria Imperial
Miller Children's and Women's Hospital Long Beach
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Inderpal Randhawa
Miller Children's and Women's Hospital Long Beach
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Nastasia Nianiaris
Miller Children's and Women's Hospital Long Beach
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Bugsu Ovunc
Miller Children's and Women's Hospital Long Beach
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Abstract

Background: Perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCA), a subset of ANCA, are associated with a multisystem vasculitis affecting small blood vessels in the body. A handful of adult patients who developed vasculitis post-COVID-19 infection have been reported. Although COVID-19 infection has been shown to drive an exaggerated immune response in the pediatric population, such as MIS-C (multisystem inflammatory syndrome in children), only one case of vasculitis following COVID-19 infection has been reported previously in children. Case presentation: Seventeen-year-old male with a past medical history of COVID-19 pneumonia two months prior presented with acute kidney injury/failure and diffuse alveolar hemorrhage (DAH). Rheumatologic workup revealed P-ANCA and Myeloperoxidase (MPO) positivity. Kidney biopsy showed necrotizing glomerulonephritis with limited immune complex deposition. Subsequently, he was treated with pulse steroids, plasmapheresis, and ultimately started on cyclophosphamide. Conclusions: To our knowledge, this report presents the second reported pediatric case of P-ANCA / MPO vasculitis following COVID-19 infection.

Peer review status:IN REVISION

05 May 2021Submitted to Pediatric Pulmonology
06 May 2021Assigned to Editor
06 May 2021Submission Checks Completed
09 May 2021Reviewer(s) Assigned
14 May 2021Review(s) Completed, Editorial Evaluation Pending
17 May 2021Editorial Decision: Revise Major
08 Jun 20211st Revision Received