Unexpected SARS-CoV-2 cardiorespiratory arrest in a myopathy patient undergoing immunosuppressive treatment: A case report
| Autor: | Nicholas L DePace, David Roshal, Stephen Soloway, Joe Colombo, Alyxandra Morgan Soloway |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Exacerbation Pneumonia Viral Asymptomatic 03 medical and health sciences Betacoronavirus 0302 clinical medicine Fatal Outcome Muscular Diseases Internal medicine Medicine Humans 030212 general & internal medicine Myopathy Pandemics Muscle biopsy medicine.diagnostic_test business.industry SARS-CoV-2 Muscle weakness COVID-19 General Medicine Hepatitis C Hepatitis B Middle Aged medicine.disease Heart Arrest Pneumonia 030220 oncology & carcinogenesis medicine.symptom business Coronavirus Infections Immunosuppressive Agents |
| Zdroj: | Medicine. 99(30) |
| ISSN: | 1536-5964 |
| Popis: | Rationale It is recommended that patients with Rheumatic diseases that are at high risk of developing active infections be screened for Tuberculosis, Hepatitis B, and Hepatitis C before receiving second-line immunosuppressive therapies. With the emergence 2019 novel coronavirus (SARS-CoV-2), expanded guidelines have not been proposed for screening in these patients before starting advanced therapy. Patient concerns We present an unique circumstance whereas a patient with a 5 year history of inflammatory muscle disease, diagnosed by clinical history and muscle biopsy with elevated creatine kinase levels, suffered a hypoxemic cardiopulmonary arrest due to asymptomatic SARS-CoV-2 after receiving advanced immunosuppressive therapy. Diagnoses The patient presented with an acute exacerbation of inflammatory muscle disease with dysphagia, muscle weakness, and elevated creatine kinase. Interventions After no improvement with intravenous immunoglobulin the patient received mycophenolate and plasma exchange therapy. Outcomes Subsequently the patient suffered a fatal hypoxemic cardiopulmonary arrest. Polymerase chain reaction test was positive for SARS-CoV-2 RNA. Lessons We conclude that rheumatic patients, asymptomatic for SARS-CoV-2 infection, be screened and tested before initiating second-line immunosuppressive treatment. |
| Databáze: | OpenAIRE |
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