☆ 3.8 Article

A Case Report of COVID-Associated Catastrophic Antiphospholipid Syndrome Successfully Treated with Eculizumab

JOURNAL OF BLOOD MEDICINE (2021)

Journal

JOURNAL OF BLOOD MEDICINE

Volume 12, Issue -, Pages 929-933

Publisher

DOVE MEDICAL PRESS LTD

DOI: 10.2147/JBM.S324873

Keywords

antiphospholipid syndrome; phospholipid autoantibodies; catastrophic APS; COVID-19; severe acute respiratory syndrome coronavirus 2; eculizumab

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Hematology

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Abstract

Antiphospholipid syndrome (APS) and its severe manifestation Catastrophic APS (CAPS) may be affected in patients with COVID-19 infection, especially in critically ill cases. COVID-19 may exacerbate the pathological effects of APS, leading to the onset of vascular diseases.

Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by multiple episodes of venous and arterial thromboses or recurrent fetal losses in the presence of antiphospholipid antibodies against beta(2)GP1, frequently accompanied by moderate thrombocytopenia. Catastrophic APS (CAPS) is a severe manifestation of APS. COVID-19 may have an intense hypercoagulable state in critically ill patients. SARS-CoV2 may potentiate pathogenic APS effects, including the activation of endothelial cells, monocytes, platelets, and complement, resulting in a proinflammatory state and prothrombotic events. The endothelial tropism of SARS-CoV2 may also modify the clinical presentation of COVID-19 in susceptible individuals and trigger flares of underlying vascular diseases. We report a case of a 64-year-old woman with a history of triple-positive APS who had multiple thrombotic and bleeding episodes after being found to have a COVID-19 infection temporally associated with CAPS development that was successfully treated with eculizumab, preventing further macro- and microvascular thrombotic events at 1 month follow-up. Our case highlights the need for more research regarding the mechanism by which COVID-19 may potentiate APS and lead to the development of CAPS.

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Letter Rheumatology

Higher risk of short term COVID-19 vaccine adverse events in myositis patients with autoimmune comorbidities: results from the COVAD study

Mrinalini Dey, R. Naveen, Elena Nikiphorou, Parikshit Sen, Sreoshy Saha, James B. Lilleker, Vishwesh Agarwal, Sinan Kardes, Jessica Day, Marcin Milchert, Mrudula Joshi, Tamer Gheita, Babur Salim, Tsvetelina Velikova, Abraham Edgar Gracia-Ramos, Ioannis Parodis, Albert Selva O'Callaghan, Minchul Kim, Tulika Chatterjee, Ai Lyn Tan, Ashima Makol, Arvind Nune, Lorenzo Cavagna, Miguel A. Saavedra, Samuel Katsuyuki Shinjo, Nelly Ziade, Johannes Knitza, Masataka Kuwana, Oliver Distler, Bhupen Barman, Yogesh Preet Singh, Rajiv Ranjan, Avinash Jain, Sapan C. Pandya, Rakesh Kumar Pilania, Aman Sharma, Manesh M. Manoj, Vikas Gupta, Chengappa G. Kavadichanda, Pradeepta Sekhar Patro, Sajal Ajmani, Sanat Phatak, Rudra Prosad Goswami, Abhra Chandra Chowdhury, Ashish Jacob Mathew, Padnamabha Shenoy, Ajay Asranna, Keerthi Talari Bommakanti, Anuj Shukla, Arunkumar R. Pande, Kunal Chandwar, John D. Pauling, Chris Wincup, Dondu Uskudar Cansu, Erick Adrian Zamora Tehozol, Jorge Rojas Serrano, Ignacio Garcia-De La Torre, Nicoletta Del Papa, Gianluca Sambataro, Atzeni Fabiola, Marcello Govoni, Simone Parisi, Elena Bartoloni Bocci, Gian Domenico Sebastiani, Enrico Fusaro, Marco Sebastiani, Luca Quartuccio, Franco Franceschini, Pier Paolo Sainaghi, Giovanni Orsolini, Rossella De Angelis, Maria Giovanna Danielli, Vincenzo Venerito, Lisa S. Traboco, Leonardo Santos Hoff, Suryo Anggoro Kusumo Wibowo, Stylianos Tomaras, Daman Langguth, Vidya Limaye, Merrilee Needham, Nilesh Srivastav, Akira Yoshida, Ran Nakashima, Shinji Sato, Naoki Kimura, Yuko Kaneko, Jesus Loarce-Martos, Sergio Prieto-Gonzalez, Albert Gil-Vila, Raquel Aranega Gonzalez, Hector Chinoy, Vikas Agarwal, Rohit Aggarwal, Latika Gupta

RHEUMATOLOGY (2023)

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Article Rheumatology

Long-term safety of COVID vaccination in individuals with idiopathic inflammatory myopathies: results from the COVAD study

Bohdana Doskaliuk, Naveen Ravichandran, Parikshit Sen, Jessica Day, Mrudula Joshi, Arvind Nune, Elena Nikiphorou, Sreoshy Saha, Ai Lyn Tan, Samuel Katsuyuki Shinjo, Nelly Ziade, Tsvetelina Velikova, Marcin Milchert, Kshitij Jagtap, Ioannis Parodis, Abraham Edgar Gracia-Ramos, Lorenzo Cavagna, Masataka Kuwana, Johannes Knitza, Yi Ming Chen, Ashima Makol, Vishwesh Agarwal, Aarat Patel, John D. Pauling, Chris Wincup, Bhupen Barman, Erick Adrian Zamora Tehozol, Jorge Rojas Serrano, Ignacio Garcia-De La Torre, Iris J. Colunga-Pedraza, Javier Merayo-Chalico, Okwara Celestine Chibuzo, Wanruchada Katchamart, Phonpen Akarawatcharangura Goo, Russka Shumnalieva, Leonardo Santos Hoff, Lina El Kibbi, Hussein Halabi, Binit Vaidya, Syahrul Sazliyana Shaharir, A. T. M. Tanveer Hasan, Dzifa Dey, Carlos Enrique Toro Gutierrez, Carlo V. Caballero-Uribe, James B. Lilleker, Babur Salim, Tamer Gheita, Tulika Chatterjee, Oliver Distler, Miguel A. Saavedra, Hector Chinoy, Vikas Agarwal, Rohit Aggarwal, Latika Gupta

Summary: Limited evidence on long-term COVID-19 vaccine safety in patients with idiopathic inflammatory myopathies (IIMs) contributes to vaccine hesitancy. This study analyzed delayed-onset vaccine adverse events (AEs) in patients with IIMs, other systemic autoimmune and inflammatory disorders (SAIDs), and healthy controls (HCs). The findings showed that vaccination is safe in individuals with IIMs, with AEs and hospitalization rates comparable to SAIDs, and mostly limited to those with autoimmune multimorbidity and active disease. These observations can inform guidelines for identifying high-risk patients in the post-vaccination period.

RHEUMATOLOGY INTERNATIONAL (2023)

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Article Medicine, General & Internal

A Case of Profound Hypertriglyceridemia Causing Pseudohypobicarbonatemia

Deepshikha Garg, Tulika Chatterjee

Summary: The light-scattering effect of hypertriglyceridemia can interfere with the photometric analysis of electrolytes, leading to errors in laboratory values. We present a case of erroneously low bicarbonate levels due to severe hypertriglyceridemia. Understanding conditions like hypertriglyceridemia that can interfere with electrolyte measurements is important in everyday clinical medicine.

CUREUS JOURNAL OF MEDICAL SCIENCE (2023)

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Article Rheumatology

Delayed adverse events following COVID-19 vaccination in patients with systemic sclerosis and other autoimmune diseases: a substudy of the COVAD-2 cohort

Suhrud Panchawagh, Doskaliuk Bohdana, Masataka Kuwana, Akira Yoshida, Keina Yomono, John D. Pauling, Ashima Makol, Esha Kadam, Jessica Day, Tulika Chatterjee, Wanruchada Katchamart, Phonpen Akarawatcharangura Goo, Elena Nikiphorou, Parikshit Sen, Dzifa Dey, Lorenzo Cavagna, Carlos Enrique Toro Gutierrez, Vishwesh Agarwal, Marcin Milchert, Nelly Ziade, Oliver Distler, C. O. V. A. D. Study COVAD Study Grp, Hector Chinoy, Rohit Aggarwal, Latika Gupta, Vikas Agarwal

Summary: This study analyzed delayed adverse events (ADEs) related to COVID-19 vaccination in patients with systemic sclerosis (SSc) and other systemic autoimmune and inflammatory disorders (SAIDs). The results showed that the risk of delayed ADEs after vaccination was not higher in SSc patients compared to other SAIDs and healthy controls. However, SSc patients with diffuse cutaneous phenotype and coexisting autoimmune conditions such as myositis and thyroid disease may be more prone to experiencing minor ADEs.

RHEUMATOLOGY INTERNATIONAL (2023)

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Article Rheumatology

High fatigue scores in patients with idiopathic inflammatory myopathies: a multigroup comparative study from the COVAD e-survey

Silvia Grignaschi, Minchul Kim, Giovanni Zanframundo, Naveen Ravichandran, James Lilleker, Parikshit Sen, Mrudula Joshi, Vishwesh Agarwal, Sinan Kardes, Jessica Day, Ashima Makol, Marcin Milchert, Tamer Gheita, Babur Salim, Tsvetelina Velikova, Abraham Edgar Gracia-Ramos, Ioannis Parodis, Elena Nikiphorou, Tulika Chatterjee, Ai Lyn Tan, Miguel Saavedra, Samuel Katsuyuki Shinjo, Nelly Ziade, Johannes Knitza, Masataka Kuwana, Arvind Nune, Oliver Distler, Hector Chinoy, Lorenzo Cavagna, Vikas Agarwal, Rohit Aggarwal, Latika Gupta, COVID Study Grp

Summary: Patients with idiopathic inflammatory myopathies (IIMs) exhibit considerable fatigue, similar to other systemic autoimmune diseases (SAIDs) and higher than healthy individuals. Women and Caucasians experience greater fatigue scores.

RHEUMATOLOGY INTERNATIONAL (2023)

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