Acute exacerbation of rheumatoid arthritis-associated interstitial lung disease triggered by COVID-19: What is the best practice for treatment?

Toshiyuki Yonezawa; Atsushi Suzuki; Kensuke Fukumitsu; Takuma Katano; Hisashi Kako; Makoto Ishii; Akio Niimi; Kazuyoshi Imaizumi; Koji Sakamoto; Norihito Omote; Etsuro Yamaguchi

Respiratory Medicine Case Reports (Jan 2023)

Acute exacerbation of rheumatoid arthritis-associated interstitial lung disease triggered by COVID-19: What is the best practice for treatment?

Toshiyuki Yonezawa,
Atsushi Suzuki,
Kensuke Fukumitsu,
Takuma Katano,
Hisashi Kako,
Makoto Ishii,
Akio Niimi,
Kazuyoshi Imaizumi,
Koji Sakamoto,
Norihito Omote,
Etsuro Yamaguchi

Affiliations

Toshiyuki Yonezawa: Department of Respiratory Medicine and Allergology, Aichi Medical University, Nagakute, Aichi, Japan; Department of Internal Medicine, Aichi Prefectural Hospital, Okazaki, Aichi, Japan
Atsushi Suzuki: Department of Internal Medicine, Aichi Prefectural Hospital, Okazaki, Aichi, Japan; Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan; Corresponding author. Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurimai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan.
Kensuke Fukumitsu: Department of Internal Medicine, Aichi Prefectural Hospital, Okazaki, Aichi, Japan; Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
Takuma Katano: Department of Respiratory Medicine and Allergology, Aichi Medical University, Nagakute, Aichi, Japan; Department of Internal Medicine, Aichi Prefectural Hospital, Okazaki, Aichi, Japan
Hisashi Kako: Department of Internal Medicine, Aichi Prefectural Hospital, Okazaki, Aichi, Japan; Department of Respiratory Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
Makoto Ishii: Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
Akio Niimi: Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan
Kazuyoshi Imaizumi: Department of Respiratory Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
Koji Sakamoto: Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
Norihito Omote: Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
Etsuro Yamaguchi: Department of Respiratory Medicine and Allergology, Aichi Medical University, Nagakute, Aichi, Japan; Department of Internal Medicine, Aichi Prefectural Hospital, Okazaki, Aichi, Japan

Journal volume & issue: Vol. 43
p. 101857

Abstract

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We present a case of 79-year-old female with rheumatoid arthritis-associated interstitial lung disease (RA-ILD) developed an acute exacerbation (AE) triggered by coronavirus disease 2019 (COVID-19). The patient was unresponsive to a combination therapy of remdesivir, dexamethasone, and tocilizumab. Given that a recent multicenter cohort study reported ILD as a poor prognostic contributor in patients with RA and COVID-19, there may be potentially a certain number of patients with AE of RA-ILD triggered by COVID-19. This case highlights the need for a discussion how to treat these patients in a daily clinical practice.

Published in Respiratory Medicine Case Reports

ISSN: 2213-0071 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the respiratory system
Website: http://www.journals.elsevier.com/respiratory-medicine-case-reports/

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