A case of psoriatic arthritis triggered by SARS-CoV-2 infection

Novelli, Lucia; Motta, Francesca; Ceribelli, Angela; Guidelli, Giacomo Maria; Luciano, N.; Isailovic, Natasa; Vecellio, Matteo; Caprioli, Marta; Clementi, Nicola; Clementi, Massimo; Mancini, Nicasio; Selmi, Carlo; Santis, Maria De

doi:10.1093/rheumatology/keaa691

Cited by 47 publications

(62 citation statements)

References 8 publications

(9 reference statements)

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“…The first case of Spondyloarthropathy triggered by SARS-CoV-2 infection was reported in a genetically predisposed (family history of psoriasis, HLA B27 negative) woman [ 37 ]. Another case was reported of a 53 year old man who developed inflammatory back pain with sacroilitis on MRI following asymptomatic COVID-19 infection [ 38 ].…”

Section: Resultsmentioning

confidence: 99%

Rheumatological complications of Covid 19

Zacharias

Dubey

Koduri

et al. 2021

Autoimmunity Reviews

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Introduction COVID-19 has caused unprecedented hardships in the 21st century with more than 150 million infections. Various immunological phenomena have been described during the course of the infection, and this infection has also triggered autoimmunity. Rheumatological illnesses have been described following resolution of the acute infection; hence we sought to conduct a review of the rheumatological complications of COVID-19. Methods We conducted a literature search for articles relating to sequelae of COVID-19 from Jan 2020 to 30th April 2021. Results We found a number of reports of inflammatory arthritis after SARS-CoV-2 infection. SLE and renal disease have been described, and vasculitis also appears to be a common complication. Rhabdomyolysis and myositis has also been reported in a number of patients. We also found some evidence of large vessel vasculitis in ‘long COVID’ patients. Conclusions This review highlights a number of important complications such as inflammatory arthritis, lupus-like disease, myostis and vasculitis following SARS-CoV-2 infection.

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Section: Resultsmentioning

confidence: 99%

Rheumatological complications of Covid 19

Zacharias

Dubey

Koduri

et al. 2021

Autoimmunity Reviews

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“…Nevertheless, direct evidence for this pathway as a potential human SpA initiator is lacking. During the global COVID-19 virus pandemic, arthralgia has been reported, raising the possibility of a poorly defined entheseal mechanism (12,13).…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 Infection Induces Psoriatic Arthritis Flares and Enthesis Resident Plasmacytoid Dendritic Cell Type-1 Interferon Inhibition by JAK Antagonism Offer Novel Spondyloarthritis Pathogenesis Insights

et al. 2021

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ObjectiveBacterial and viral infectious triggers are linked to spondyloarthritis (SpA) including psoriatic arthritis (PsA) development, likely via dendritic cell activation. We investigated spinal entheseal plasmacytoid dendritic cells (pDCs) toll-like receptor (TLR)-7 and 9 activation and therapeutic modulation, including JAK inhibition. We also investigated if COVID-19 infection, a potent TLR-7 stimulator triggered PsA flares.MethodsNormal entheseal pDCs were characterized and stimulated with imiquimod and CpG oligodeoxynucleotides (ODN) to evaluate TNF and IFNα production. NanoString gene expression assay of total pDCs RNA was performed pre- and post- ODN stimulation. Pharmacological inhibition of induced IFNα protein was performed with Tofacitinib and PDE4 inhibition. The impact of SARS-CoV2 viral infection on PsA flares was evaluated.ResultsCD45+HLA-DR+CD123+CD303+CD11c- entheseal pDCs were more numerous than blood pDCs (1.9 ± 0.8% vs 0.2 ± 0.07% of CD45+ cells, p=0.008) and showed inducible IFNα and TNF protein following ODN/imiquimod stimulation and were the sole entheseal IFNα producers. NanoString data identified 11 significantly upregulated differentially expressed genes (DEGs) including TNF in stimulated pDCs. Canonical pathway analysis revealed activation of dendritic cell maturation, NF-κB signaling, toll-like receptor signaling and JAK/STAT signaling pathways following ODN stimulation. Both tofacitinib and PDE4i strongly attenuated ODN induced IFNα. DAPSA scores elevations occurred in 18 PsA cases with SARS-CoV2 infection (9.7 ± 4 pre-infection and 35.3 ± 7.5 during infection).ConclusionEntheseal pDCs link microbes to TNF/IFNα production. SARS-CoV-2 infection is associated with PsA Flares and JAK inhibition suppressed activated entheseal plasmacytoid dendritic Type-1 interferon responses as pointers towards a novel mechanism of PsA and SpA-related arthropathy.

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“…Aside from rhabdomyolysis, a few cases of arthritis associated with COVID-19 infection have been reported [11] , [12] , [13] , [14] , [15] , [16] . Indeed, a systematic review of rheumatologic findings in COVID-19 patients concludes that muscle pain and fatigue are present in 19% and 32% of patients as an initial presentation, with an overall prevalence of 16% and 36% throughout the course of the disease, respectively [17] .…”

Section: Discussionmentioning

confidence: 99%

Bilateral shoulder arthritis in COVID-19 patient after prolonged mechanical ventilation assist: a case report

Neves¹,

Lourenço²,

Alves³

et al. 2021

Radiology Case Reports

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Prolonged immobilization and, in particular, mechanical ventilation, have been linked to muscle atrophy. Anecdotal reports in the literature describe rhabdomyolysis as a potential late complication of COVID-19 infection which, in severe cases, may coexist with fluid collections. We report a case of a 28-year-old patient that had been recently hospitalized with SARS-CoV-2 pneumonia, with need for invasive ventilation support. Days after being discharged, the patient presents with retrosternal thoracalgia irradiating to the left upper limb. On physical examination, abduction and external rotation were limited due to pain complaints and there was soft tissue swelling of the corresponding shoulder and arm. Imaging evaluation was essential to establish the underlying condition, revealing bilateral arthritis communicating with large rotator cuff collections, which was considered of septic nature.

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A case of psoriatic arthritis triggered by SARS-CoV-2 infection

Cited by 47 publications

References 8 publications

Rheumatological complications of Covid 19

Rheumatological complications of Covid 19

SARS-CoV-2 Infection Induces Psoriatic Arthritis Flares and Enthesis Resident Plasmacytoid Dendritic Cell Type-1 Interferon Inhibition by JAK Antagonism Offer Novel Spondyloarthritis Pathogenesis Insights

Bilateral shoulder arthritis in COVID-19 patient after prolonged mechanical ventilation assist: a case report

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