IgA vasculitis with transient glomerular hematuria, diarrhea, and pericarditis following COVID-19 mRNA vaccination in a young patient with possible pre-existing ulcerative colitis.

Exacerbations or de novo autoimmune/autoinflammatory disease have been reported after COVID-19 vaccination. A young male presented with cutaneous IgA vasculitis with glomerular hematuria, diarrhea and pericarditis following his second COVID-19 mRNA vaccination. He also showed positivity for proteinase 3 anti-neutrophil cytoplasmic antibody (PR3-ANCA) and anti-cardiolipin antibody. Skin biopsy was compatible to IgA vasculitis. His purpura subsided and hematuria spontaneously disappeared. Treatment with anti-inflammatory medications and prednisolone resolved the pericarditis. He had a history of persistent diarrhea, and colonic biopsies showed possible ulcerative colitis without vasculitis. Kidney biopsy after prednisolone therapy revealed minor glomerular abnormalities without any immune reactants and did not show vasculitis. After prednisolone treatment, PR3-ANCA decreased in a medium degree despite of improvement of symptoms and inflammatory data, suggesting that his PR3-ANCA may be associated with ulcerative colitis. The cause of the transient glomerular hematuria was unclear, however, it might be caused by focal glomerular active lesions (glomerular vasculitis) due to vaccine-induced IgA vasculitis with nephritis. This case highlights that COVID-19 mRNA vaccination can activate multiple autoimmune/autoinflammatory systems. The conditions might help us better understand the mutual mechanisms of the relevant disorders.

Improvement of spatial resolution in the longitudinal direction for isotropic imaging in helical CT.

Experiments were conducted to confirm the isotropic spatial resolution of multislice CT with a 0.5 mm slice thickness. Isotropic spatial resolution means that the spatial resolution in the transaxial plane (X-Y plane) and that in the longitudinal direction (Z direction) are equivalent. To obtain point spread function (PSF) values in the X-Y-Z directions, three-dimensional voxel data were obtained by helical scanning of a bead phantom. The modulation transfer function (MTF) values were then obtained by three-dimensional Fourier transform of the PSF. Evaluation of the spatial resolution in the X-Y-Z directions by the MTF values showed that the spatial resolution in the Z direction does not depend on the reconstruction kernel used. It was also found that the spatial resolution in the Z direction, as compared with that in the X-Y plane, is superior with the standard kernel for the abdomen and is inferior with the high-definition kernel for the ears/bones. By performing sharpening filter processing in the Z direction with a high-definition kernel, comparable spatial resolution could be obtained in the X-Y-Z directions. It was confirmed that adjusting the spatial resolution in the Z direction with the reconstruction kernel used is an effective method for isotropic imaging.