Purpose
Reactive arthritis is acute aseptic arthritis occurring 1 to 4 weeks after a distant infection in a genetically predisposed individual. It may occur after COVID-19 infection.
We summarize, in this article, the current findings of reactive arthritis following COVID-19 infection.
Methods
A literature search has been performed from December 2019 to December 2021. We included case reports of reactive arthritis occurring after COVID-19 infection. We collected demographic, clinical, and paraclinical data.
Results
A total of 22 articles were reviewed. There were 14 men and 11 women with a mean age of 44.96 + 17.47 years. Oligoarticular involvement of the lower limbs was the most frequent clinical presentation. The time between arthritis and COVID infection ranged from 6 to 48 days. The diagnosis was based on clinical and laboratory findings. The pharmacological management was based on non-steroidal anti-inflammatory drugs in 20 cases. Systemic or local steroid therapy was indicated in 13 patients. Sulfasalazine was indicated in two cases. Alleviation of symptoms and recovery were noted in 22 cases. The mean duration of the clinical resolution was 16 + 57 days.
Conclusion
The diagnosis of reactive arthritis should be considered in patients with a new onset of arthritis following COVID-19 infection. Its mechanism is still unclear.
A 68-year-old female presented with inflammatory lumbalgia and cruralgia. Physical examination revealed a lumbar stiffness without neurological deficit. Secondarily, paraplegia and urinary retention appeared. Magnetic resonance imaging showed a vertebral compaction of L3 vertebra with medullar compression. Emergent surgery revealed an epidural tumor involving largely the L3 vertebral body. Histology found schwannoma with positive protein S100 on the immunohistochemical study. Metastasis screening revealed bilateral nodular lesions of the lungs and a trochanter high scintigraphic signal. It was a malignant schwannoma. The patient underwent radiotherapy in addition to the total tumor resection.
Digital ulcers (DU) are a well-known problem in patients with systemic sclerosis. It is an underestimated complication of the disease causing pain and morbidity. Essential thrombocytosis is another cause of DU. The association of theses two diseases increases the risk of ischemic complications and impairment of hand function which are frequently observed in patients with digital ulcers. This report deals with a 68-year-old patient with rare association of Essential thrombocytosis ,Systemic sclerosis and Raynaud's phenomenon that was refractory to medical treatment of Systemic sclerosis (illoprost,calcium channel blockers) and improved with hydrea R .
Background:
C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are routinely used to assess
disease activity in spondyloarthritis. New biomarkers have been reported, such as neutrophil to lymphocyte ratio (NLR),
platelet to lymphocyte ratio (PLR), CRP to albumin ratio (CAR), and albumin to fibrinogen ratio (AFR).
Our study aimed to assess these ratios in spondyloarthritis and to determine the relationship between these ratios and the
disease activity.
Methods:
We conducted a cross-sectional study, including patients with spondyloarthritis. The following ratios were
calculated: PLR, NLR, AFR, and CAR. Pearson correlation analysis was carried out to test the correlation of the data.
Receiver operating characteristic curves were evaluated for each ratio using ASDASCRP as the gold standard for disease
activity.
Results:
Eighty-five patients were included. The sex ratio was 60 males to 25 females. The mean age was 42.58 ± 11.75
years. There was a positive correlation between the PLR and the following parameters: CAR, CRP, and ESR. A negative
correlation was found between AFR and the following ratios: PLR, NLR, CRP, and ESR. The ASDAS correlated
negatively with AFR and positively with both PLR and CAR. The cut-offs values of CAR and PLR to distinguish patients
with very high disease activity (ASDASCRP>3.5) were 0.442 and 173.64, respectively.
Conclusions:
Given their good correlation with ESR and CRP, we suggest that PLR, CAR, and AFR can be used as
potential indicators of inflammation in spondyloarthritis. The CAR and PLR are useful to identify patients with very high
disease activity.
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