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Eur Rev Med Pharmacol Sci ; 24(22): 11960-11963, 2020 11.
Article in English | MEDLINE | ID: covidwho-962031


Though the exact etiology of autoimmune diseases still remains not completely known, there are various factors which are known to contribute to be trigger of autoimmune diseases. Viral infection is known to be among the other. It is known as the infection from severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) can be an autoimmune trigger, so, we suppose that SARS-Coronavirus (SARS-CoV-2) could be as well. Several authors have highlighted the temporal consequence between SARS-CoV-2 and autoimmune diseases. In this case report we described a patient admitted for COVID-19 pneumonia with completely negative autoimmunity at admission who developed major pulmonary interstitial disease. During the hospitalization the weaning difficulties from oxygen led us to the repetition of autoimmunity pattern which became positive (both during hospitalization then after two months from dismission) with marked positivity for specific antibodies for myositis even after the patient's infectious healing. In the follow-up, the patient continued to have asthenia and muscle weakness despite steroid therapy. She is still in follow-up and will be further evaluated over time. Can we therefore think that in this case the development of autoimmunity can persist beyond the infectious phase and determine over time the development of a real autoimmune myositis?

Autoantibodies/immunology , Autoimmune Diseases/immunology , COVID-19/immunology , Lung Diseases, Interstitial/immunology , Muscle Weakness/immunology , Myositis/immunology , Aged , Antibodies, Antineutrophil Cytoplasmic/immunology , Antibodies, Antinuclear/immunology , Antigens, Nuclear/immunology , Asthenia/immunology , Autoimmune Diseases/drug therapy , Autoimmune Diseases/etiology , Autoimmune Diseases/physiopathology , COVID-19/complications , COVID-19/physiopathology , COVID-19/therapy , Female , Humans , Ku Autoantigen/immunology , Mi-2 Nucleosome Remodeling and Deacetylase Complex/immunology , Myositis/drug therapy , Myositis/etiology , Myositis/physiopathology
Rheumatol Int ; 40(10): 1539-1554, 2020 10.
Article in English | MEDLINE | ID: covidwho-646938


The coronavirus disease-2019 (COVID-19) pandemic is likely to pose new challenges to the rheumatology community in the near and distant future. Some of the challenges, like the severity of COVID-19 among patients on immunosuppressive agents, are predictable and are being evaluated with great care and effort across the globe. A few others, such as atypical manifestations of COVID-19 mimicking rheumatic musculoskeletal diseases (RMDs) are being reported. Like in many other viral infections, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can potentially lead to an array of rheumatological and autoimmune manifestations by molecular mimicry (cross-reacting epitope between the virus and the host), bystander killing (virus-specific CD8 + T cells migrating to the target tissues and exerting cytotoxicity), epitope spreading, viral persistence (polyclonal activation due to the constant presence of viral antigens driving immune-mediated injury) and formation of neutrophil extracellular traps. In addition, the myriad of antiviral drugs presently being tried in the treatment of COVID-19 can result in several rheumatic musculoskeletal adverse effects. In this review, we have addressed the possible spectrum and mechanisms of various autoimmune and rheumatic musculoskeletal manifestations that can be precipitated by COVID-19 infection, its therapy, and the preventive strategies to contain the infection.

Autoimmune Diseases/physiopathology , Coronavirus Infections/physiopathology , Musculoskeletal Diseases/physiopathology , Pneumonia, Viral/physiopathology , Rheumatic Diseases/physiopathology , Antibodies, Antinuclear/immunology , Antibodies, Antiphospholipid/immunology , Antiviral Agents/adverse effects , Arthralgia/etiology , Arthralgia/immunology , Arthralgia/physiopathology , Autoimmune Diseases/etiology , Autoimmune Diseases/immunology , Betacoronavirus , Blood Coagulation Disorders/etiology , Blood Coagulation Disorders/immunology , Blood Coagulation Disorders/physiopathology , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/drug therapy , Coronavirus Infections/immunology , Cross Reactions/immunology , Extracellular Traps/immunology , Fibrin Fibrinogen Degradation Products , Guillain-Barre Syndrome/etiology , Guillain-Barre Syndrome/immunology , Guillain-Barre Syndrome/physiopathology , Humans , Lupus Coagulation Inhibitor/immunology , Molecular Mimicry , Mucocutaneous Lymph Node Syndrome/etiology , Mucocutaneous Lymph Node Syndrome/immunology , Mucocutaneous Lymph Node Syndrome/physiopathology , Muscle Weakness/etiology , Muscle Weakness/immunology , Muscle Weakness/physiopathology , Musculoskeletal Diseases/etiology , Musculoskeletal Diseases/immunology , Myalgia/etiology , Myalgia/immunology , Myalgia/physiopathology , Myocarditis/etiology , Myocarditis/immunology , Myocarditis/physiopathology , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/drug therapy , Pneumonia, Viral/immunology , Rheumatic Diseases/etiology , Rheumatic Diseases/immunology , SARS-CoV-2 , COVID-19 Drug Treatment