Bolig Thomas C, Abdulaziz Nada, Schiopu Elena
Department of Internal Medicine, University of Michigan, 1500 E Medical Ctr Dr, Ann Arbor, MI 48109, USA.
Department of Rheumatology, University of Michigan, 1500 E Medical Ctr Dr, Ann Arbor, MI 48109, USA.
Case Rep Rheumatol. 2020 Oct 21;2020:8886324. doi: 10.1155/2020/8886324. eCollection 2020.
Immune-mediated necrotizing myopathy (IMNM) is a rare form of idiopathic immune myopathy (IIM) that requires immunotherapies, including immunosuppressive medications, if severe. There is a paucity of data regarding outcomes of patients with immune-mediated polymyositis who continue immunosuppressive medications during the COVID-19 pandemic. This is the first reported case of COVID-19 in a patient with IMNM. Despite being on two immunotherapies, having risk factors, and having radiographic abnormalities on chest X-ray, the patient had an unremarkable COVID-19 course. He was discharged from the emergency department with a 7-day course of azithromycin and quickly resumed his immunotherapies, but he experienced a flare in his myositis. The 14-week follow-up computed tomography (CT) was negative for residual pneumonitis or fibrosis. More data are needed regarding management and prognosis of patients with connective tissue diseases who become infected with SARS-CoV-2.
免疫介导的坏死性肌病（IMNM）是一种罕见的特发性免疫性肌病（IIM），病情严重时需要免疫治疗，包括免疫抑制药物。关于在新冠疫情期间继续使用免疫抑制药物的免疫介导性多肌炎患者的预后数据很少。这是首例报道的IMNM患者感染新冠病毒的病例。尽管该患者正在接受两种免疫治疗，存在危险因素，胸部X光检查有影像学异常，但他的新冠病程并无异常。他从急诊科出院时接受了为期7天的阿奇霉素治疗，并很快恢复了免疫治疗，但他的肌炎病情出现了复发。14周后的计算机断层扫描（CT）显示，残留肺炎或纤维化呈阴性。对于感染了严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的结缔组织病患者的管理和预后，还需要更多数据。
