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Post a Comment Development of Waterhouse–Friderichsen syndrome after infection with SARS-CoV-2 against the background of comorbidity
- Authors: Alpidovskaya О.V.1
-
Affiliations:
- Chuvash State University
- Issue: Vol 15, No 1 (2024)
- Pages: 113-119
- Section: Case reports
- URL: https://journals.rcsi.science/clinpractice/article/view/257944
- DOI: https://doi.org/10.17816/clinpract472056
- ID: 257944
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Abstract
BACKGROUND: The COVID-19 pandemic has also affected rheumatic diseases. A clinical case of the development of Waterhouse–Friderichsen syndrome after SARS-CoV-2 infection in a patient with secondary AA adrenal amyloidosis is presented.
CLINICAL CASE DESCRIPTION: Patient G., 57 years old, was hospitalized for several hours on May 20, 2023 at the Cheboksary Regional Hospital with the following diagnosis: “Severe viral interstitial pneumonia. Secondary AA adrenal amyloidosis. Acute adrenal insufficiency”. She was admitted with complaints of a febrile temperature up to 38.2°C. Computed tomography of the chest organs showed signs of bilateral viral interstitial pneumonia (the percentage of lung damage was 74%). The diagnosis of COVID-19 was based on a positive polymerase chain reaction test performed on nasopharyngeal swabs. The blood pressure was 80/40 mm Hg, D-dimer 786 ng/ml (with the normal values of not higher than 243 ng/ml). Despite the treatment, the patient died. An autopsy revealed dystelectasis, hyaline membranes, intraalveolar edema in the lungs, and the deposition of amyloid masses, foci of necrosis of the cortical layer and hemorrhage in the adrenal glands. Signs of disseminated intravascular coagulation syndrome were found.
CONCLUSION: The peculiarity of the case is the development of Waterhouse–Frideriksen syndrome without signs of sepsis.
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##article.viewOnOriginalSite##About the authors
Оlga V. Alpidovskaya
Chuvash State University
Author for correspondence.
Email: olavorobeva@mail.ru
ORCID iD: 0000-0003-3259-3691
SPIN-code: 5084-1379
МD, PhD
Russian Federation, CheboksaryReferences
- Склянова М.В., Калягин А.Н., Щербаков Г.И., Зимина И.А. Амилоидоз в практике врача-ревматолога // Байкальский медицинский журнал. 2009. № 3. С. 150–152. [Sklyanova MV, Kalyagin AN, Shcherbakov GI, Zimina IA. Amyloidosis in the practice of a rheumatologist. Baikal Medical Journal. 2009;(3):150–152. (In Russ).]
- Михалева Л.М., Гиоева З.В., Рёкен К. Гистологическое и иммуногистохимическое исследование в диагностике амилоидоза печени // Архив патологии. 2015. Т. 77, № 4. С. 11–16. [Mikhaleva LM, Gioeva ZV, Rёken K. Histological and immunohistochemical examinations in the diagnosis of hepatic amyloidosis. Arkhiv Patologii. 2015;77(4):11–16. (In Russ).] doi: 10.17116/patol201577411-16
- Насонов Е.Л. Коронавирусная болезнь 2019 (COVID-19): размышления ревматолога // Научно-практическая ревматология. 2020. Т. 58, № 2. С. 123–132. [Nasonov EL. Coronavirus disease 2019 (COVID-19): Reflections from a rheumatologist. Scientific Practical Rheumatology. 2020;58(2):123–132. (In Russ).]
- Smatti MK, Cyprian FS, Nasrallah GK, et al. Viruses and autoimmunity: A review on the potential interaction and molecular mechanisms. Viruses. 2019;11(8):E762. doi: 10.3390/v11080762
- Joo YB, Lim YH, Kim KJ, et al. Respiratory viral infections and the risk of rheumatoid arthritis. Arthritis Res Ther. 2019;21(1):199. doi: 10.1186/s13075-019-1977-9
- Santana MF, Borba MG, Baía-da-Silva DC, et al. Case report: Adrenal pathology findings in severe COVID-19: An autopsy study. Am J Trop Med Hyg. 2020;103(4):1604–1607. doi: 10.4269/ajtmh.20-0787
- Iuga AC, Marboe CC, Yilmaz M, et al. Adrenal vascular changes in COVID-19 Autopsies. Arch Pathol Lab Med. 2020;144(10): 1159–1160. doi: 10.5858/arpa.2020-0248-LE
- Porfidia A, Pola R. Venous thromboembolism in COVID-19 patients. J Thromb Haemost. 2020;18(6):1516–1517. doi: 10.1111/jth.14842
- Leyendecker P, Ritter S, Riou M, Wackenthaler A, Meziani F, Roy C, Ohana M. Acute adrenal infarction as an incidental CT finding and a potential prognosis factor in severe SARS-CoV-2 infection: a retrospective cohort analysis on 219 patients. Eur Radiol. 2021 Feb;31(2):895–900. doi: 10.1007/s00330-020-07226-5
- Qin C, Zhou L, Hu Z, et al. Dysregulation of immune response in patients with COVID-19 in Wuhan, China. Clin Infect Dis. 2020;71(15):762–768. doi: 10.1093/cid/ciaa248
- Воробьева О.В., Ласточкин А.В., Гималдинова Н.Е. Клинико-морфологическая характеристика случая системного AL-амилоидоза // Современные проблемы науки и образования. 2020. № 3. С. 151. [Vorobeva OV, Lastochkin AV, Gimaldinova NE. Clinical and morphological characteristic case of system AL-amyloidosis. Modern Problems of Science and Education. Surgery. 2020;(3):151. (In Russ).] doi: 10.17513/spno.29795
- Воробьева О.В., Романова Л.П. Изменения органов после инфицирования SARS-CoV-2 у пациентки с системной склеродермией по данным аутопсии. Современная ревматология. 2022. Т. 16, № 2. С. 69–73. [Vorobeva OV, Romanova LP. Organ changes after SARS-CoV-2 infection in a patient with systemic sclerosis according to autopsy. Modern Rheumatology Journal. 2022;16(2):69–73. (In Russ).] doi: 10.14412/1996-7012-2022-2-69-73
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