COVID-19 infection may trigger SLE disease: a case report

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect various organs of the body especially the skin, joints, hematopoietic system, kidneys and central nervous system. The signs and symptoms occur depending on the inflammation in the affected tissues. Although many factors are responsible in its aetiology, it is known that some viruses such as Epstein Bar may also cause this disease by triggering autoimmunity. Recent studies have revealed that immune system could be activated due to coronavirus infections and that some autoantibodies could be seen in blood. A small number of SLE cases activated by COVID infection have been reported in the literature. In the present study, a 20-year-old patient with COVID infection, who was diagnosed with SLE with renal involvement according to EULAR/ACR 2019 criteria by considering histopathological and immunofluorescence findings, is presented and discussed with the information in the literature.

Keywords:

Lupus Erythematosus, systemic, COVID-19, Antibodies, Autoimmune Diseases,

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1. Lin YS, Lin CF, Fang YT, Kuo YM, Liao PC, Yeh TM, et al. Antibody to severe acute respiratory syndrome (SARS)-associated coronavirus spike protein domain 2 cross-reacts with lung epithelial cells and causes cytotoxicity. Clin Exp Immunol 2005; 141(3): 500–508.
2. Diao B, Wang C, Tan Y, Chen X, Liu Y, Ning L, et al. Reduction and Functional Exhaustion of T Cells in Patients With Coronavirus Disease 2019 (COVID-19). Front Immunol 2020;11:827.
3. Zhou Y, Han T, Chen J, Hou C, Hua L, He S, et al. Clinical and Autoimmune Characteristics of Severe and Critical Cases of COVID-19. Clin Transl Sci 2020;13:1077–1086.
4. Rubino S, Kelvin N, Bermejo-Martin JF, Kelvin D. As COVID-19 cases, deaths and fatality rates surge in Italy, underlying causes require investigation. J Infect Dev Ctries 2020;31;14(3):265-267.
5. Huet T, Beaussier H, Voisin O, Jouveshomme S, Dauriat G, Lazareth I, et al. Anakinra for severe forms of COVID-19: a cohort study. Lancet Rheumatol 2020;2: 393–400.
6. Bonometti R, Sacchi MC, Stobbione P, Lauritano EC, Tamiazzo S, Marchegiani A, et al. The first case of systemic lupus erythematosus (SLE) triggered by COVID-19 infection. Eur Rev Med Pharmacol Sci 2020;24: 9695–9697.
7. Mantovani Cardoso E, Hundal J, Feterman D, Magaldi J. Concomitant new diagnosis of systemic lupus erythematosus and COVID-19 with possible antiphospholipid syndrome. Just a coincidence? A case report and review of intertwining pathophysiology. Clin Rheumatol 2020;39(9):2811–2815.
8. Gracia-Ramos AE, Saavedra-Salinas MÁ. Can the SARS-CoV-2 infection trigger systemic lupus erythematosus? A case-based review. Rheumatol Int 2021;41: 799–809.
9. Zamani B, Moeini Taba S-M, Shayestehpour M. Systemic lupus erythematosus manifestation following COVID-19: a case report. J Med Case Rep 2021;15: 29.
10. Aringer M, Costenbader K, Daikh D, Brinks R, Mosca M, Ramsey-Goldman R, et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Ann Rheum Dis 2019;78: 1151–1159.
11. Barbhaiya M, Costenbader KH. Environmental exposures and the development of systemic lupus erythematosus . Curr Opin Rheumatol 2016;28: 497–505.
12. Losa F, Firinu D, Deidda M, Costanzo G, Del Giacco SR. Clinical pitfalls of leishmaniasis and Whipple's disease hidden behind systemic lupus erythematosus: A case series. Acta Microbiol Immunol Hung 2019;66: 377-385.
13. Li Z-X, Zeng S, Wu H-X, Zhou Y. The risk of systemic lupus erythematosus associated with Epstein-Barr virus infection: a systematic review and meta-analysis. Clin Exp Med 2019;19: 23–36.
14. Ramos-Casals M. Viruses and lupus: the viral hypothesis. Vol. 17, Lupus. England: 2008;163–165.
15. Wang Y, Sun S, Shen H, Jiang L, Zhang M, Xiao D, et al. Cross-reaction of SARS-CoV antigen with autoantibodies in autoimmune diseases. Cell Mol Immunol 2004;1:304–307.
16. Wang YS, Shen H, Sun SH, Jiang LH, Liu Y, Zhu ZW, et al. Analysis of false-positive associated with antibody tests for SARS-CoV in SLE patients. Shi Yan Sheng Wu Xue Bao 2003;36, 314–317.
17. Wu H-S, Chiu S-C, Tseng T-C, Lin S-F, Lin J-H, Hsu Y-H, et al. Serologic and molecular biologic methods for SARS-associated coronavirus infection, Taiwan. Emerg Infect Dis 2004;10, 304–310.

Journal of Experimental and Clinical Medicine-Cover

Yayın Aralığı: Yılda 4 Sayı
Başlangıç: 1980
Yayıncı: Ondokuz mayıs Üniversitesi Tıp Fakültesi

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