New onset granulomatous with polyangiitis in a Covid-19 patient: A case report

Background: Granulomatosis with polyangiitis (GPA) is a systemic necrotizing vasculitis affecting small to medium-sized blood vessels. COVID-19 pandemic, originating in Wuhan, China in 2019, has led to significant global morbidities and mortalities across the world up to now (3). Autoimmune reactions can be triggered by various factors, including infections and vaccines, contributing to ANCA-associated vasculitis. Case report: A 41-year-old male with history of HTN was hospitalized with complaints of fatigue, abdominal pain, shortness of breath and gross haematuria. The patient had history of hospitalization due to severe Covid-19 last year and was hospitalized hospitalized due to concurrent diffuse alveolar hemorrhage. Laboratory investigations revealed elevated ESR, CRP, proteinuria (+2) and haematuria (+4) and positive C-ANCA. Discussion: We presented a de novo case of wegener’s disease with bronchiectasis in a previously healthy individual. ANCA-associated glomerulonephritis may potentially arise both SARS-Cov2 infection and vaccinations. Proper management and diagnosis of Wegener’s disease requires multidisciplinary collaboration. Overlapping clinical manifestations of GPA with other pathologies and diseases may lead to misdiagnosis, thus high clinical suspicion is crucial. Conclusion: Granulomatosis with polyangiitis (GPA) is a rare autoimmune vasculitis, affecting small- medium sized blood vessels and is characterized by necrotizing granulomatous vasculitis caused by autoantibodies against anti-proteinase3 (PR3). SARS-CoV-2 infection is associated with either development of de novo autoimmune disease or flaring of preexisting autoimmunity. Further researches are warranted for investigation of long-term complications of SARS-CoV-2 infection in high-risk individuals.