A case of HLA-B27 positive reactive arthritis associated with SARS-CoV2 infection

Apaydın, Hakan

doi:10.14744/nci.2020.88965

Cited by 5 publications

(20 citation statements)

References 6 publications

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“…Systemic or local steroid therapy was indicated in 13 patients. Sulfasalazine was indicated in two cases [ 32 , 36 ]. Alleviation of symptoms and recovery were noted in 22 cases.…”

Section: Resultsmentioning

confidence: 99%

“…The mean duration of the clinical resolution was 16 + 57 days. Persistent arthralgia was reported in two patients [ 32 , 35 ]. Clinical follow-up was not available in one case.…”

Section: Resultsmentioning

confidence: 99%

“…The authors suggested that HLA B27 is responsible for chronic synovial inflammation. In these cases, Conventional Disease-modifying Anti Rheumatic drugs such as sulfasalazine have been indicated [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…Synovial fluid PCR may also be performed to confirm the sterile nature of the disease [ 5 , 18 , 30 ]. Inflammatory markers are commonly raised and may reach significant values, mimicking septic arthritis [ 20 , 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

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Reactive arthritis occurring after COVID-19 infection: a narrative review

et al. 2022

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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.

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“…Systemic or local steroid therapy was indicated in 13 patients. Sulfasalazine was indicated in two cases [ 32 , 36 ]. Alleviation of symptoms and recovery were noted in 22 cases.…”

Section: Resultsmentioning

confidence: 99%

“…The mean duration of the clinical resolution was 16 + 57 days. Persistent arthralgia was reported in two patients [ 32 , 35 ]. Clinical follow-up was not available in one case.…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Reactive arthritis occurring after COVID-19 infection: a narrative review

et al. 2022

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“…While non-steroid anti-inflammatory drugs (NSAIDs) were used in two paediatric patients, 10 no specific treatment was used in the third paediatric patient 9 and none of them progressed to chronicity of the arthritis. Alivernini et al 11 reported that NSAIDs, baricitinib and glucocorticoids were started, Apaydın et al 12 reported that hydroxychloroquine (HCQ), glucocorticoids and sulfasalazine were started, Liew et al 13 reported that NSAIDs were started and intra-articular triamcinolone was administered in the knee joint and Talarico et al 14 reported that medium doses of glucocorticoids were started. There was one case in which the patient did not achieve remission before publication of the article 12 and the remaining where chronicity was not reported.…”

Section: Resultsmentioning

confidence: 99%

COVID-19-associated arthritis: an emerging new entity?

2022

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The current COVID-19 pandemic raises several clinical challenges. Cases of COVID-19-associated arthritis have been reported, and inconsistently described as either COVID-19 viral arthritis or COVID-19 reactive arthritis. We aimed to review all the reported cases of ‘COVID-19-associated arthritis’, which we propose, is a better term to define the entire spectrum of new-onset arthritis believed to be associated with SARS-CoV-2 infection. We performed a systematic literature review using MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews to search for articles published up to 13 December 2021. We included cohort studies, case series and case reports describing patients diagnosed with COVID-19 reactive or viral arthritis by a physician, irrespective of fulfilment of classification criteria. To identify relevant studies, medical subject headings and keywords related to ‘COVID-19/SARS-CoV-2 infection’ and ‘reactive arthritis’ were used. Our search retrieved 419 articles, of which 31 were included in the review. A total of 33 cases were reported in these 31 articles, the majority being adults (28/33=85%) with peripheral joint involvement (26/33=79%). Most of the patients responded well to treatment and the disease was self-limiting. These 33 case reports describe a possible causal relationship between exposure to SARS-CoV-2 and the onset of arthritis. However, since these cases were reported during a pandemic, other aetiologies cannot be fully excluded. The exact mechanism through which SARS-CoV-2 might trigger arthritis is not fully understood and robust epidemiological data to support a causal relationship are still lacking.

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COVID‐associated arthritis after severe and non‐severe COVID‐19: A systematic review

Zarpoosh,

Amirian

2023

Immunity Inflam & Disease

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AimSince the coronavirus outbreak became a global health emergency in 2020, various immune‐based effects, such as inflammatory arthritis (IA), have been recorded. This study aimed to determine the role of COVID‐19 severity on post‐COVID arthritis.MethodsWe systematically reviewed 95 patients who developed arthritis after severe and non‐severe COVID‐19 infection by searching the databases, including PubMed, SCOPUS, and EMBASE. We used the term “COVID‐associated arthritis” because there was no definite diagnostic method for classifying arthritides after COVID‐19 infection, and the diagnosed arthritis types were based on the authors' viewpoints.ResultsAfter evaluating the data between the two severe and non‐severe COVID‐19‐infected groups of patients, the results showed that the COVID‐19 severity may affect the pattern of joint involvement in IA. In both groups, combination therapy, including oral nonsteroidal anti‐inflammatory drugs with different types of corticosteroids, was the most common treatment. In addition, the mean age and comorbidities rate was higher in the severe COVID‐19 group. Even though the patients in the severe COVID‐19 group developed more serious COVID‐19 symptoms, they experienced milder arthritis with better outcomes and more delayed onsets that required less aggressive therapy.ConclusionWe conclude that there may be an inverse relationship between COVID‐19 severity and arthritis severity, possibly due to weaker immunity conditions following immunosuppressant treatments in patients with severe COVID‐19.

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A case of HLA-B27 positive reactive arthritis associated with SARS-CoV2 infection

Cited by 5 publications

References 6 publications

Reactive arthritis occurring after COVID-19 infection: a narrative review

Reactive arthritis occurring after COVID-19 infection: a narrative review

COVID-19-associated arthritis: an emerging new entity?

COVID‐associated arthritis after severe and non‐severe COVID‐19: A systematic review

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