Reactive arthritis after COVID-19 infection.
Keisuke Ono,Mitsumasa Kishimoto,Teppei Shimasaki,Hiroko Uchida,Daisuke Kurai,Gautam A. Deshpande,Yoshinori Komagata,Shinya Kaname +7 more
TLDR
The first case of ReA after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is reported, in a male patient who was admitted with COVID-19 pneumonia and subsequently completing a 14-day course of favipiravir.Abstract:
Reactive arthritis (ReA) is typically preceded by sexually transmitted disease or gastrointestinal infection. An association has also been reported with bacterial and viral respiratory infections. Herein, we report the first case of ReA after the he severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This male patient is in his 50s who was admitted with COVID-19 pneumonia. On the second day of admission, SARS-CoV-2 PCR was positive from nasopharyngeal swab specimen. Despite starting standard dose of favipiravir, his respiratory condition deteriorated during hospitalisation. On the fourth hospital day, he developed acute respiratory distress syndrome and was intubated. On day 11, he was successfully extubated, subsequently completing a 14-day course of favipiravir. On day 21, 1 day after starting physical therapy, he developed acute bilateral arthritis in his ankles, with mild enthesitis in his right Achilles tendon, without rash, conjunctivitis, or preceding diarrhoea or urethritis. Arthrocentesis of his left ankle revealed mild inflammatory fluid without monosodium urate or calcium pyrophosphate crystals. Culture of synovial fluid was negative. Plain X-rays of his ankles and feet showed no erosive changes or enthesophytes. Tests for syphilis, HIV, anti-streptolysin O (ASO), Mycoplasma, Chlamydia pneumoniae, antinuclear antibody, rheumatoid factor, anticyclic citrullinated peptide antibody and Human Leukocyte Antigen-B27 (HLA-B27) were negative. Gonococcal and Chlamydia trachomatis urine PCR were also negative. He was diagnosed with ReA. Nonsteroidal Anti-Inflammatory Drug (NSAID)s and intra-articular corticosteroid injection resulted in moderate improvement.read more
Citations
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The intersection of COVID-19 and autoimmunity.
Jason S. Knight,Roberto Caricchio,Jean-Laurent Casanova,Alexis J. Combes,Betty Diamond,Sharon E. Fox,David A. Hanauer,Judith A. James,Yogendra Kanthi,Virginia Ladd,Puja Mehta,Aaron M. Ring,Ignacio Sanz,Carlo Selmi,Russell P. Tracy,Paul J. Utz,Catriona A. Wagner,Julia Y. Wang,W. Joseph McCune +18 more
TL;DR: The potential role of auto-immunity in post-acute sequelae of COVID-19 pneumonia was discussed in this paper, highlighting the current understanding, evolving concepts, and unanswered questions provided by this unique opportunity to determine mechanisms by which a viral infection can be exacerbated by, and even trigger, auto-IMM.
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COVID-19 and the clinical course of rheumatic manifestations.
TL;DR: The manifestations of COVID-19 have been evolving over time as discussed by the authors, and various post-COVID19 syndromes are being recognised, including reactive arthritis and connective tissue disorders such as lupus and inflammatory myositis.
Journal ArticleDOI
Musculoskeletal involvement of COVID-19: review of imaging.
Santhoshini Leela Ramani,Jonathan D. Samet,Colin K. Franz,Colin K. Franz,Christine Hsieh,Cuong V. Nguyen,Craig Horbinski,Swati Deshmukh +7 more
TL;DR: In this article, the authors provide a comprehensive summary of musculoskeletal manifestations of COVID-19 with review of imaging, including myositis, neuropathy, arthropathy, and soft tissue abnormalities.
Journal ArticleDOI
Post-COVID-19 arthritis: a case report and literature review.
TL;DR: In this paper, a case of acute oligoarthritis occurring 13 days after a severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) severe pneumonia in a middle-aged Caucasian man was described.
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Reactive arthritis: clinical aspects and medical management.
John D. Carter,Alan P. Hudson +1 more
TL;DR: Diagnostic criteria for ReA exist, but data suggest new criteria are needed, and epidemiologic and prospective studies have been difficult to perform because of over-reliance on the complete classic triad of symptoms and the different terms and eponyms used.
Journal ArticleDOI
HLA-B27-Associated Reactive Arthritis: Pathogenetic and Clinical Considerations
TL;DR: Current evidence supports the concept that reactive arthritis (ReA) is an immune-mediated synovitis resulting from slow bacterial infections and showing intra-articular persistence of viable, nonculturable bacteria and/or immunogenetic bacterial antigens synthesized by metabolically active bacteria residing in the joint and/ or elsewhere in the body.
Journal ArticleDOI
Diagnosis and classification of reactive arthritis
Carlo Selmi,M. Eric Gershwin +1 more
TL;DR: The presence of large joint oligoarthritis, urogenital tract infection, and uveitis characterizes Reiter's syndrome as a clinical subtype and diagnostic criteria are based on the ACR guidelines and include rheumatological signs along with a proof of infection.
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