Onset and Relapse of Juvenile Dermatomyositis Following Asymptomatic SARS-CoV-2 Infection
2021; Springer Science+Business Media; Volume: 42; Issue: 1 Linguagem: Inglês
10.1007/s10875-021-01119-y
ISSN1573-2592
AutoresMathieu P. Rodero, Stéphane Pelleau, A. Welfringer‐Morin, Darragh Duffy, Isabelle Melki, Brigitte Bader‐Meunier, Vincent Bondet, Cyril Gitiaux, J. Bonigen, Antoine Fayand, Laurence Courdavault Vagh Weinmann, E. Mahé, Jean Luc Charuel, Marie-Alexandra Alyanakian, Jean Philippe Herbeuva, Michael White,
Tópico(s)Eosinophilic Disorders and Syndromes
ResumoDear Editor, SARS-CoV-2 infection drives a marked inflammation and has been described to precede the appearance in rare occasion of various autoimmune and inflammatory diseases including clinical, radiological, muscle biopsy, and serological features consistent with dermatomyositis [1,2].A working hypothesis is that juvenile dermatomyositis (JDM) is a type 1 interferon-driven inflammatory response, triggered by one or more environmental stimuli, such as infection.In order to test the hypothesis that SARS-CoV-2 could promote JDM, we studied SARS-CoV-2 infection history in the 10 JDM patients with disease onset (n = 6) or relapse (n = 4) seen in our center since the start of the pandemic.IgG and IgM directed against 5 different portions of the virus were measured in patients plasma at the time of diagnosis: whole spike protein, spike receptor-binding domain (RBD), spike S2 subunit, nucleocapsid protein (NP), and a membrane-envelope fusion glycoprotein (ME) [3].Out of the 10 patients, we identified high titers of both IgG (Fig. 1a) and IgM (Fig. 1b) antibodies directed against SARS-CoV-2 proteins in one new onset (P1) and one relapsing patient (P2) (Fig. 1a) indicating a recent history of infection by SARS-CoV-2.P1 is a 15-year-old girl that developed a JDM associating poor general state, fatigue, weight loss, symmetrical polyarthritis, mild proximal muscle weakness, and skin features: erythema and papule at the joint extensors, erythema and painful hyperkeratosis papules palmar and plantar, purple eyelids, and telangiectasia at the root of nails and gingival margins.Muscle biopsy's features were consistent with the diagnosis of JDM.Creatine kinase (CK) was elevated 545 U/L (< 150).She was negative for muscle-specific
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