Objective Coronavirus disease 19 (COVID-19) has an increased risk of coagulopathy with high frequency of antiphospholipid antibodies (aPL). Recent reports of thrombosis associated with adenovirus-based vaccines raised concern that SARS-CoV-2 immunization in primary antiphospholipid syndrome (PAPS) patients may trigger clotting complications. Our objectives were to assess immunogenicity, safety, and aPL production in PAPS patients, after vaccinating with Sinovac-CoronaVac, an inactivated virus vaccine against COVID-19. Methods This prospective controlled phase-4 study of PAPS patients and a control group (CG) consisted of a two-dose Sinovac-CoronaVac (D0/D28) and blood collection before vaccination (D0), at D28 and 6 weeks after second dose (D69) for immunogenicity/aPL levels. Outcomes were seroconversion (SC) rates of anti-SARS-CoV-2 S1/S2 IgG and/or neutralizing antibodies (NAb) at D28/D69 in naïve participants. Safety and aPL production were also assessed. Results We included 44 PAPS patients (31 naïve) and 132 CG (108 naïve) with comparable age ( p=0.982) and sex ( p>0.999). At D69, both groups had high and comparable SC (83.9% vs. 93.5%, p=0.092), as well as NAb positivity (77.4% vs. 78.7%, p=0.440), and NAb-activity (64.3% vs. 60.9%, p=0.689). Thrombotic events up to 6 months or other moderate/severe side effects were not observed. PAPS patients remained with stable aPL levels throughout the study at D0 vs. D28 vs. D69: anticardiolipin (aCL) IgG ( p=0.058) and IgM ( p=0.091); anti-beta-2 glycoprotein I (aβ2GPI) IgG ( p=0.513) and IgM ( p=0.468). Conclusion We provided novel evidence that Sinovac-CoronaVac has high immunogenicity and safety profile in PAPS. Furthermore, Sinovac-CoronaVac did not trigger thrombosis nor induced changes in aPL production.

No abstract

BACKGROUNDCardiac involvement in Takayasu's arteritis (TA), a large vessel vasculitis (LLV) that affects patients at a young age, is an important cause of morbidity and mortality. Cardiac manifestations include hypertension and involvement of the cardiac valves, myocardium and coronary arteries. However, inflammatory cardiomyopathy (cardiac dysfunction as a consequence of myocarditis), is rarely reported. Therefore, we reported a case of dilated cardiomyopathy secondary to myocarditis at disease onset of TA.

No abstract

No abstract

BACKGROUNDThe most common etiologic agents of septic arthritis (SA) are Gram-positive organisms (e.g., Staphylococcus aureus), with approximately 15% being due to Gram-positive and Gram-negative organisms. Infection by Pseudomonas aeruginosa occurs typically in patients with a history of intravenous drug use, malignancy, prosthetic devices, and advanced age. SA typically affects one joint but may be polyarticular in up to 20% of cases (most commonly in immunocompromised patients). Here we report a case of polyarticular SA caused by P. aeruginosa in a patient with severe chronic comorbidities. CASE REPORTA 45-year-old male patient was admitted to the gastroenterology department due to a week history of fever and joint pain. From comorbidities, he had a diagnosis of ulcerative colitis with primary sclerosing cholangitis (PSC) and had been submitted to liver transplantation in 2012. However, he had recurrence of PSC with several hospitalizations due to progressive liver failure, hepatic encephalopathy, and infectious complications in the last 3 years. The current clinical picture started with fever (39° C) and painful swelling in the right knee with rapid evolution (3 days) to arthritis in the small joints of the hands, wrists, shoulders, and knees. Physical examination revealed intense pain on palpation and swelling in the hands, wrists, elbows, in addition to marked joint blockage in the right knee. Laboratory tests showed increased acute phase reagents (C-reactive protein 244.9 mg/dL) and impaired renal and hepatic functions. He underwent arthrocentesis and joint lavage of the right knee, as well as antibiotic treatment with ceftriaxone (2 g intravenous IV per day) and vancomycin (2 g IV per day). Blood and synovial fluid cultures showed P. aeruginosa multi-S. In this context, antibiotic therapy was optimized according to antibiogram (cephalosporins) Despite the treatment, the patient evolved with rapidly progressive multiorgan dysfunction and an unfavorable outcome with death.

No abstract

No abstract