TY - JOUR
T1 - A periaortitis patient who succumbed to covid-19 while undergoing systemic steroid therapy
T2 - A case report and literature review
AU - Abu Baker, Ammar
AU - Aljarrah, Qusai
AU - Eyadeh, Mohammad Asim
AU - Al-Muqbel, Kusai
AU - Allouh, Mohammed Z.
N1 - Publisher Copyright:
© Am J Case Rep, 2021;.
PY - 2021
Y1 - 2021
N2 - Objective: Background: Case Report: Conclusions: Unusual clinical course Periaortitis is an inflammatory condition that typically involves the infrarenal portion of the abdominal aorta. It is a rare disease usually occurring in middle-aged men. Coronavirus disease-2019 (COVID-19) is caused by the SARS-CoV-2 virus. The published literature on the management of steroid therapy in patients with periaortitis and infected with SARS-CoV-2 is lacking. The balance between the indispensable anti-inflammatory properties of steroids and their adverse immunosuppressive characteristics remains unclear in the current COVID-19 sce-nario, and most of the current practices in managing potentially autoimmune aortic conditions are extrapolat-ed from patients with rheumatological disorders contracting COVID19 while undergoing maintenance steroid therapy. This report describes the case of a 62-year-old man who presented with nonspecific lower abdominal pain, unremarkable clinical exam, significantly elevated CRP level, and positive antinuclear antibody test. A CT scan showed mild aortic aneurysmal dilatation with periaortic soft tissue thickening, and a PET scan confirmed the finding, showing active abdominal periaortitis. Accordingly, he was diagnosed with autoimmune periaortitis and was maintained on a high dose of systemic corticosteroids (35 mg prednisolone/d). Eight weeks later, he was readmitted to the intensive care unit with worsening respiratory symptoms due to SARS-CoV-2 infection confirmed by PCR test, and unfortunately died 44 days later due to COVID-19-induced respiratory failure and sepsis. The lack of an international consensus on the management of SARS-CoV-2-positive, steroid-dependent patients with serious inflammatory aortic conditions mandates further investigations and thoughtful review of the guidelines for the management of steroid-dependent patients contracting SARS-CoV-2 infection. Additionally, a comprehensive analysis of the outcomes of these patients is essential.
AB - Objective: Background: Case Report: Conclusions: Unusual clinical course Periaortitis is an inflammatory condition that typically involves the infrarenal portion of the abdominal aorta. It is a rare disease usually occurring in middle-aged men. Coronavirus disease-2019 (COVID-19) is caused by the SARS-CoV-2 virus. The published literature on the management of steroid therapy in patients with periaortitis and infected with SARS-CoV-2 is lacking. The balance between the indispensable anti-inflammatory properties of steroids and their adverse immunosuppressive characteristics remains unclear in the current COVID-19 sce-nario, and most of the current practices in managing potentially autoimmune aortic conditions are extrapolat-ed from patients with rheumatological disorders contracting COVID19 while undergoing maintenance steroid therapy. This report describes the case of a 62-year-old man who presented with nonspecific lower abdominal pain, unremarkable clinical exam, significantly elevated CRP level, and positive antinuclear antibody test. A CT scan showed mild aortic aneurysmal dilatation with periaortic soft tissue thickening, and a PET scan confirmed the finding, showing active abdominal periaortitis. Accordingly, he was diagnosed with autoimmune periaortitis and was maintained on a high dose of systemic corticosteroids (35 mg prednisolone/d). Eight weeks later, he was readmitted to the intensive care unit with worsening respiratory symptoms due to SARS-CoV-2 infection confirmed by PCR test, and unfortunately died 44 days later due to COVID-19-induced respiratory failure and sepsis. The lack of an international consensus on the management of SARS-CoV-2-positive, steroid-dependent patients with serious inflammatory aortic conditions mandates further investigations and thoughtful review of the guidelines for the management of steroid-dependent patients contracting SARS-CoV-2 infection. Additionally, a comprehensive analysis of the outcomes of these patients is essential.
KW - COVID-19
KW - Methylprednisolone
KW - Prednisolone
KW - Retroperitoneal Fibrosis
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U2 - 10.12659/AJCR.932733
DO - 10.12659/AJCR.932733
M3 - Article
C2 - 34415896
AN - SCOPUS:85113173514
SN - 1941-5923
VL - 22
JO - American Journal of Case Reports
JF - American Journal of Case Reports
IS - 1
M1 - e932733
ER -