Article Text

Download PDFPDF

Glucocorticoid-induced relapse of COVID-19 in a patient with sarcoidosis
Free
  1. Andrea Hermina Györfi1,
  2. Markus Kopp2,
  3. Matthias May2,
  4. Marcel Vetter3,
  5. Michael Uder2,
  6. Andreas E Kremer3,
  7. Georg Schett1,
  8. Thomas Harrer1,
  9. Jörg H W Distler1
  1. 1 Department of Internal Medicine 3—Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Bayern, Germany
  2. 2 Department of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
  3. 3 Department of Internal Medicine 1—Gastroenterology, Pneumology and Endocrinology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
  1. Correspondence to Dr Jörg H W Distler, Department of Internal Medicine 3—Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen 91054, Germany; joerg.distler{at}uk-erlangen.de

Statistics from Altmetric.com

The COVID-19 pandemic represents a challenge for rheumatologists: how activity of rheumatological diseases or disease-modifying therapies may affect the outcome of SARS-CoV-2 infection is only beginning to be understood. Gianfrancesco et al provided important insights in this regard by evaluating the hospitalisation rate of 600 patients with rheumatological diseases from 40 different countries.1 They found that glucocorticoid treatment in doses equivalent with prednisolone 10 mg/day or higher was associated with an increased hospitalisation rate.

Here, we describe the case of a 50-year-old man who was diagnosed with Löfgren syndrome in January 2019 presenting with cough, bilateral ankle joint swelling and mediastinal lymphadenopathy. ACE (37.3 U/L, normal range <21.4) and soluble IL-2 receptor (1445 U/mL, normal range <710) were elevated in the serum. The patient was treated with glucocorticoids until October 2019 with complete remission of clinical symptoms and normalisation of laboratory parameters.

On 12 March 2020, the patient had contact with a person who later tested positive for SARS-CoV-2 RNA. One week after the SARS-CoV-2 contact, the patient developed fever (38°C) and dry cough suggesting SARS-CoV-2 infection. In addition, he developed pain in the ankles during night …

View Full Text

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles