A Case of Systemic Lupus Erythematosus Flare Triggered by Severe Coronavirus Disease 2019

Raghavan, Sairam; Gonakoti, Sriram; Asemota, Iriagbonse; Benjamín,

doi:10.1097/rhu.0000000000001531

Cited by 41 publications

(59 citation statements)

References 8 publications

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“…Of the 8 patients (including ours), 6 (75%) were women with a median age of 48 years (range 18-85 years) ( Table 2). Five cases (63%) occurred in patients with previous history of SLE (one case with associated antiphospholipid syndrome and another case with end-stage renal disease secondary to WHO Class IV lupus nephritis) [11,12,14,16,17]. The nonspeci c clinical manifestations reported were fever in 5 cases [12,13,16,17 and present report], malaise in 3 cases [13,17 and present report], 1 case with headache [14] and 1 case with myalgia and arthralgia [present report]).…”

Section: Resultsmentioning

confidence: 66%

“…Five cases (63%) occurred in patients with previous history of SLE (one case with associated antiphospholipid syndrome and another case with end-stage renal disease secondary to WHO Class IV lupus nephritis) [11,12,14,16,17]. The nonspeci c clinical manifestations reported were fever in 5 cases [12,13,16,17 and present report], malaise in 3 cases [13,17 and present report], 1 case with headache [14] and 1 case with myalgia and arthralgia [present report]). Organ-speci c manifestations reported were pulmonary (cough in 4 cases [13,14,17 and present report], shortness of breath in 4 cases [12][13][14], chest discomfort in 1 case [11] and peripheral cyanosis in 1 case [15]), cardiovascular (2 cases with circulatory collapse [13,15]), hematological (hemoptysis in 1 case [16], gingival bleeding in 1 case [11] and 1 case with diffuse purpuric rash [14] [11,13,14], positive anticardiolipin antibodies in 2 cases [13,14], and positive anti-β2-glycoprotein 1 antibodies in 2 cases [13,14].…”

Section: Resultsmentioning

confidence: 66%

“…After removing the duplicate citations, title and abstracts of 48 articles were reviewed, and 9 articles relevant to the topic of the review were reviewed to detail. Seven case reports were found to be relevant to this research ( Figure 2) [11][12][13][14][15][16][17]. With the present report, a total of 8 cases were included for this review.…”

Section: Resultsmentioning

confidence: 99%

“…Reported SLE activity was hematologic in 6 patients [11,13- [13,17]. The diagnosis of SARS-CoV-2 infection was made by PCR test in 7 patients [11][12][13][14]16,17] and by serologic test in 1 patient [15]. Imaging studies found bilateral pleural effusion in 3 cases [13,15 and present case], patchy ground-glass opacities in 5 cases (one with chronic interstitial lung brosis) [12][13][14]16,17], bilateral reticular pattern with vascular enlargement in 1 case [present case], pericardial effusion with tamponade in 1 case [13] and impaired left ventricle ejection fraction in 1 case [13].…”

Section: Resultsmentioning

confidence: 99%

“…The diagnosis of SARS-CoV-2 infection was made by PCR test in 7 patients [11][12][13][14]16,17] and by serologic test in 1 patient [15]. Imaging studies found bilateral pleural effusion in 3 cases [13,15 and present case], patchy ground-glass opacities in 5 cases (one with chronic interstitial lung brosis) [12][13][14]16,17], bilateral reticular pattern with vascular enlargement in 1 case [present case], pericardial effusion with tamponade in 1 case [13] and impaired left ventricle ejection fraction in 1 case [13]. The treatment used in patients with a previous diagnosis of SLE included hydroxychloroquine-belimumab-azathioprine-warfarin [16]; hydroxychloroquinemycophenolic acid [12,17]; prednisone [11]; and no therapy [14].…”

Section: Resultsmentioning

confidence: 99%

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Systemic Lupus Erythematosus triggered by SARS-CoV-2 Infection: A Systematic Review Based on a Case Report

Gracia‐Ramos¹,

Saavedra-Salinas²

2020

Preprint

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Systemic lupus erythematosus (SLE) is an autoimmune and multisystemic chronic inflammatory disease that can affect various organs, including skin, joints, kidneys, lungs and the nervous system. Infectious agents have long been implicated in the pathogenesis of SLE. The new viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has shown that, in genetically predisposed patients, could trigger the presentation or exacerbation of autoimmune disease. We herein report a case of a 45-year-old man who presented respiratory symptoms, bilateral pleural effusion, ascites, splenomegaly, severe thrombocytopenia and renal failure with proteinuria and hematuria. SARS-CoV-2 PCR confirmed the COVID-19 diagnosis. We diagnosed the patient with SLE based on the clinical manifestations and positive immunological markers (2019 European League Against Rheumatism/American College of Rheumatology score of 18). Glucocorticoid pulses were administered to the patient with improvement in renal function. However, thrombocytopenia was also refractory to IV immunoglobulin and rituximab, so the patient underwent splenectomy. Through a systematic search of the medical literature, we retrieved 2 cases with SLE new onset and 5 cases with previous SLE diagnosis that shown activity of disease due SARS-CoV-2 infection. We herein present a systemic review of these cases and discuss the clinical manifestations that could help to the diagnosis of this clinical condition.

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Section: Resultsmentioning

confidence: 66%

Section: Resultsmentioning

confidence: 66%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Systemic Lupus Erythematosus triggered by SARS-CoV-2 Infection: A Systematic Review Based on a Case Report

Gracia‐Ramos¹,

Saavedra-Salinas²

2020

Preprint

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Can the SARS-CoV-2 infection trigger systemic lupus erythematosus? A case-based review

Gracia‐Ramos

Saavedra-Salinas

2021

Rheumatol Int

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Systemic lupus erythematosus (SLE) is an autoimmune and multisystemic chronic inflammatory disease that can affect various organs, including skin, joints, kidneys, lungs and the nervous system. Infectious agents have long been implicated in the pathogenesis of SLE. The new viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has shown that, in genetically predisposed patients could trigger the presentation or exacerbation of the autoimmune disease. We herein report a case of a 45-year-old man who presented respiratory symptoms, bilateral pleural effusion, ascites, splenomegaly, severe thrombocytopenia and renal failure with proteinuria and hematuria. SARS-CoV-2 PCR confirmed the COVID-19 diagnosis. We diagnosed the patient with SLE based on the clinical manifestations and positive immunological markers (2019 European League Against Rheumatism/American College of Rheumatology, score of 18). Glucocorticoid pulses were administered to the patient, which improved renal function. However, thrombocytopenia was also refractory to IV immunoglobulin and rituximab, so the patient underwent splenectomy. Through a systematic search of the medical literature, we retrieved two cases with newly onset SLE and five cases with previous SLE diagnosis that showed activity of the disease due to SARS-CoV-2 infection. We herein present a systemic review of these cases and discuss the clinical manifestations that could help to the diagnosis of this clinical condition.

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Rheumatology university faculty opinion on coronavirus disease-19 (COVID-19) vaccines: the vaXurvey study from Egypt

et al. 2021

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Objectives The aim of the present work was to explore the perspectives of Egyptian Rheumatology staff members as regards the coronavirus disease-19 (COVID-19) vaccine. Methods The survey is composed of 25 questions. Some questions were adapted from the global rheumatology alliance COVID-19 survey for patients. Results 187 rheumatology staff members across Egypt from 18 universities and authorizations actively participated with a valid response. The mean time needed to complete the survey was 17.7 ± 13 min. Participants were 159 (85%) females (F:M 5.7:1). One-third agreed that they will be vaccinated once available, 24.6% have already received at least one dose, 29.4% are unsure while 16% will not take it. Furthermore, 70.1% agreed that they will recommend it to the rheumatic diseases (RD) patients once available, 24.1% are not sure while 5.9% will not recommend it. RD priority to be vaccinated against COVID-19 in descending order include SLE (82.9%), RA (55.1%), vasculitis (51.3%), systemic sclerosis (39.6%), MCTD (31.6%), Behcet's disease (28.3%). The most common drugs to be avoided before vaccination included biologics (71.7%), DMARDs (44.4%), biosimilars (26.7%), IVIg (17.1%) and NSAIDs (9.1%). Conclusions The results of the study and specifically the low rate of acceptability are alarming to Egyptian health authorities and should stir further interventions to reduce the levels of vaccine hesitancy. As rheumatic disease patients in Egypt were not systematically provided with the vaccine till present, making the vaccine available could as well enhance vaccine acceptance. Further studies to investigate any possible side effects, on a large scale of RD patients are warranted.

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A Case of Systemic Lupus Erythematosus Flare Triggered by Severe Coronavirus Disease 2019

Cited by 41 publications

References 8 publications

Systemic Lupus Erythematosus triggered by SARS-CoV-2 Infection: A Systematic Review Based on a Case Report

Systemic Lupus Erythematosus triggered by SARS-CoV-2 Infection: A Systematic Review Based on a Case Report

Can the SARS-CoV-2 infection trigger systemic lupus erythematosus? A case-based review

Rheumatology university faculty opinion on coronavirus disease-19 (COVID-19) vaccines: the vaXurvey study from Egypt

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