PT  - JOURNAL ARTICLE
AU  - Sukhraj Singh
AU  - Zareen Vaghaiwalla
AU  - Myint Thway
AU  - Gurjit Singh Kaeley
TI  - Does withdrawal of immunosuppression in rheumatoid arthritis after SARS-CoV-2 infection increase the risk of vasculitis?
AID  - 10.1136/bcr-2020-241125
DP  - 2021 Apr 01
TA  - BMJ Case Reports
PG  - e241125
VI  - 14
IP  - 4
4099  - http://casereports.bmj.com/content/14/4/e241125.short
4100  - http://casereports.bmj.com/content/14/4/e241125.full
SO  - BMJ Case Reports2021 Apr 01; 14
AB  - We describe a case of a 48-year-old woman who presented with acute respiratory failure due to diffuse alveolar haemorrhage and acute renal failure due to pauci-immune glomerulonephritis consistent with a new diagnosis of microscopic polyangiitis (MPA). The patient had a recent SARS-CoV-2 infection 6 weeks before MPA diagnosis and had stopped immunosuppression for her rheumatoid arthritis (RA) at that time. The patient was treated with pulse intravenous steroids, plasma exchange therapy and rituximab, which induced remission of her illness. This case highlights a timely dilemma of holding immunosuppression in a RA patient with low disease activity on combination therapy with SARS-CoV-2 infection, and the potential risk of developing an additional autoimmune disease, such as vasculitis, given their existing autoimmunity due to RA.