Alharthy Abdulrahman, Faqihi Fahad, Nasim Nasir, Noor Alfateh, Akhtar Saima, Balshi Ahmed, Balhamar Abdullah, Alqahtani Saleh A, Memish Ziad A, Karakitsos Dimitrios
Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia.
Department of Medicine, The Johns Hopkins University Hospital, Baltimore, MD, USA.
Respir Med Case Rep. 2020;31:101252. doi: 10.1016/j.rmcr.2020.101252. Epub 2020 Oct 15.
This is a rare case-report of a young female with systemic lupus erythematosus and end-stage kidney disease (on maintenance hemodialysis) who was admitted to our intensive care unit due to life-threatening COVID-19. The patient was diagnosed with a flare of lupus; while being on maintenance hydroxychloroquine therapy. However, after the administration of steroids she made an uneventful recovery and was discharged home. In this report, the diagnostic dilemmas and the therapeutic challenges due to the overlapping clinical, imaging, and laboratory findings between lupus and COVID-19 pneumonitis are outlined. In conclusion, patients with lupus may be affected by COVID-19 despite the administration of hydroxychloroquine. The administration of steroids may have a beneficial effect on mitigating both the flare of SLE and the COVID-19 associated hyperinflammation.
这是一例罕见的病例报告，一名患有系统性红斑狼疮和终末期肾病（维持性血液透析）的年轻女性因危及生命的新型冠状病毒肺炎（COVID-19）入住我们的重症监护病房。该患者在接受维持性羟氯喹治疗时被诊断为狼疮病情活动。然而，在使用类固醇后，她顺利康复并出院回家。本报告概述了由于狼疮和COVID-19肺炎在临床、影像学和实验室检查结果上重叠而导致的诊断困境和治疗挑战。总之，尽管使用了羟氯喹，狼疮患者仍可能感染COVID-19。使用类固醇可能对减轻系统性红斑狼疮（SLE）病情活动和与COVID-19相关的过度炎症有有益作用。
