Infection or autoimmunity? The clinical challenge of interstitial lung disease in systemic sclerosis during the COVID-19 pandemic
| Autor: | Stefano Colagrande, Cosimo Bruni, Martina Orlandi, Musataka Kuwana, Marco Matucci-Cerinic, Nicholas Landini |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
systemic sclerosis Immunology computed tomography (CT) Scleroderma Malaise 03 medical and health sciences 0302 clinical medicine Rheumatology Anticentromere antibody positivity Informed consent Internal medicine medicine Immunology and Allergy 030212 general & internal medicine 030203 arthritis & rheumatology interstitial lung disease business.industry emergency pandemic Interstitial lung disease COVID-19 medicine.disease Dermatology Pulmonary hypertension medicine.symptom Differential diagnosis business |
| Popis: | To the Editor: The novel coronavirus disease 2019 (COVID-19) pandemic is a world emergency that may inevitably complicate the clinical scenario of interstitial lung disease (ILD) secondary to systemic sclerosis (SSc)1,2. The striking similarities in computed tomography (CT) between the 2 diseases make it difficult to distinguish a worsening of SSc-ILD from a COVID-19 superinfection2. For this reason, we present a case of a 67-year-old woman affected by limited cutaneous SSc with anticentromere antibody positivity, characterized by Raynaud phenomenon for 10 years, and skin involvement but no ILD or pulmonary hypertension. She was treated with symptomatic drugs but no immunosuppressive therapy. According to national and local regulations, approval by the ethics committee is not required for a case report. We obtained the patient’s informed consent to publish the material. The patient was seen in January 2020 because of mild fever (37.5°C), malaise, and cough. First, she was treated with ampicillin/minocycline. Due to symptom persistence, she underwent a lung CT, which revealed bilateral, multilobar, rounded ground-glass opacities (GGO), in both the upper and lower lobes (Figure 1A). Initially, the upper lobe involvement raised the suspicion of a pulmonary infection. However, the predominant peripheral, symmetrical, and basal distribution of GGO areas could not rule out the suspicion of early SSc-ILD. Given the ongoing pandemic, a COVID-19 reverse transcription PCR test was performed, with … Address correspondence to Dr. M. Orlandi, Department of Clinical and Experimental Medicine, University of Florence, & Department of Geriatric Medicine, Division of Rheumatology AOUC, Padiglione 28c Ponte Nuovo, piano 1, Via delle Oblate, 4, Florence, Italy. Email: martina.orlandi{at}unifi.it. |
| Databáze: | OpenAIRE |
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