COVID-19 and adult-onset Still's disease as part of hyperferritinemic syndromes.
Mod Rheumatol Case Rep
; 6(1): 101-105, 2022 01 07.
Article
in English
| MEDLINE | ID: covidwho-1443057
ABSTRACT
The coronavirus disease (COVID-19) is known to cause hyperferritinemia and haemophagocytic lymphohistiocytosis. Including this laboratory parameter, symptoms similar to COVID-19 have been observed in adult-onset Still's disease (AOSD), catastrophic antiphospholipid syndrome, macrophage activation syndrome, and septic shock, which has led to the proposal of a concept called 'hyperferritinemic syndromes'. High levels of some clinical markers in both COVID-19 and AOSD make them difficult to differentiate. While the efficacy of ciclesonide had been expected for mild pneumonia with COVID-19, the efficacy of tocilizumab (TCZ), which is a known treatment for AOSD, was not established. We report the first known occurrence of COVID-19 diagnosed in March 2020, preceded by the diagnosis of AOSD in April 2019. The patient was given prednisolone and TCZ, which led to remission. With the dyspnea and ground-glass appearance on chest computed tomography, PCR test revealed COVID-19 infection. Ciclesonide was started on Day 7 of the disease onset, which led to improved inflammatory markers. We infer that while TCZ is theoretically useful for COVID-19 due to its inhibition of interleukin 6. AOSD and COVID-19 may be differentiated by levels of ferritin, and appropriate treatment must be allocated.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Still's Disease, Adult-Onset
/
Macrophage Activation Syndrome
/
COVID-19
/
COVID-19 Drug Treatment
Type of study:
Case report
/
Diagnostic study
/
Prognostic study
Limits:
Adult
/
Humans
Language:
English
Journal:
Mod Rheumatol Case Rep
Year:
2022
Document Type:
Article
Affiliation country:
Mrcr
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