Microscopic Polyangiitis is a “Masquerade Ball” in Modern Realities: A Literature Review

Abstract

Microscopic polyangiitis (MPA) is an important new medical problem, as it shows increasing incidence and prevalence in the population, especially after the outbreak of coronavirus disease 2019 (COVID-19). MPA is a multisystemic destructive disease with a wide spectrum of heterogeneous clinical manifestations depending on the affected organs. The polymorphism of nonspecific clinical signs and the variability of the clinical picture, which differs from patient to patient, can cause a diagnostic delay and establish the correct diagnosis only in the late stages of the disease. That is why many patients consult and receive treatment from different doctors before verifying the diagnosis. In the review article, an analysis of literary sources was made, which highlighted classic renal and/or pulmonary symptoms, skin, gastrointestinal, neurological and cardiovascular manifestations of MPA. It is important to note that the clinical manifestations of MPA can be very different from the usual recognized patterns and manifest as unusual manifestations of the disease with a hidden or atypical course, and therefore received the figurative name “the Great Masquerades”. So MPA can often hide under the “mask” of other diseases, including COVID-19 itself, which significantly complicates its early diagnosis and treatment. That is why doctors should be better informed about the different variants of the clinical course of MPA and approaches to diagnosis, which will help eliminate delays in diagnosis. After all, the rapid diagnosis of MPA is important for the initiation of adequate immunosuppressive therapy, which can both save lives, preserve organs from damage, and improve the quality of life.