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Published on: December 19, 2020
Secondary Polymyalgia Rheumatica Following SARS-CoV-2 Infection
Kazuki Ocho1, Hideharu Hagiya2, Hisashi Ishikawa1
1Department of Internal Medicine, Ishikawa Hospital.
Insights
The novel coronavirus disease 2019 (COVID-19) may trigger polymyalgia rheumatica (PMR), an autoimmune condition. Prompt treatment with prednisolone effectively managed the patient's symptoms, suggesting a link between SARS-CoV-2 infection and PMR onset.
Area of Science:
- Rheumatology
- Infectious Diseases
- Immunology
Background:
- Polymyalgia rheumatica (PMR) is an inflammatory condition typically affecting individuals over 50.
- The etiology of PMR is often idiopathic, but viral triggers have been suspected.
- The emergence of SARS-CoV-2 has raised questions about its potential to trigger autoimmune responses.
Observation:
- An 81-year-old male with diabetes and hypertension developed bilateral shoulder and hip pain 3 days after COVID-19 diagnosis.
- Symptoms consistent with PMR appeared one month after initial SARS-CoV-2 infection onset.
- The patient presented to an outpatient clinic for evaluation of persistent pain.
Findings:
- Diagnostic criteria for polymyalgia rheumatica were met.
- Treatment with 15 mg of prednisolone daily resulted in immediate symptom improvement.
- The clinical presentation strongly suggests SARS-CoV-2 infection as a trigger for PMR.
Implications:
- This case highlights a potential novel association between SARS-CoV-2 infection and the development of polymyalgia rheumatica.
- Understanding post-COVID-19 autoimmune manifestations is crucial for patient management.
- Further research is warranted to explore the immunopathogenesis linking SARS-CoV-2 to PMR.
Abstract:
An 81-year-old Japanese man with a medical history of diabetes mellitus and hypertension was diagnosed with the novel coronavirus disease 2019 (COVID-19). The patient developed pain in the bilateral shoulders and hips 3 days after the disease onset and presented to our outpatient clinic after 1 month. Referring to diagnostic criteria, we diagnosed him with polymyalgia rheumatica (PMR). We initiated prednisolone at 15 mg per day and his symptoms improved immediately. The clinical course of the patient indicated that the SARS-CoV-2 infection triggered the onset of autoimmune disease, PMR in this case.
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