Gokhale Yojana, Patankar Aditi, Holla Usha, Shilke Mrinal, Kalekar Lalana, Karnik Niteen D, Bidichandani Kushal, Baveja Sujata, Joshi Anagha
Professor of Medicine, In charge of Rheumatology Services, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra.
Lecturer in Medicine, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra.
J Assoc Physicians India. 2020 Nov;68(11):20-24.
Viruses have been shown to modify the clinical picture of several autoimmune diseases, including type 1 diabetes, systemic lupus erythematosus (SLE), rheumatoid arthritis and multiple sclerosis. Viral infections have also been considered as a possible trigger for autoimmune disorders like myositis through myositis specific antibodies. Dermatomyositis is an acquired inflammatory myopathy which is relatively rare with incidence of 9.3 per 1 million persons. Usually we come across 1-2 patients of dermatomyositis per year, amongst 800-1000 new patients in our tertiary care rheumatology services. A surge in the incidence was noted this year during the months of April-August of 2020, the period coinciding with the occurrence of corona virus (COVID-19) pandemic in the city of Mumbai, the total number of cases encountered being five in a span of six months. The following case series includes five such cases with review of available literature on virus-triggered autoimmunity with special reference to SARS-CoV-2 and the challenges of immunosuppression during this pandemic.
病毒已被证明会改变多种自身免疫性疾病的临床表现,包括1型糖尿病、系统性红斑狼疮(SLE)、类风湿性关节炎和多发性硬化症。病毒感染也被认为是引发自身免疫性疾病如肌炎的一个可能诱因,通过肌炎特异性抗体发挥作用。皮肌炎是一种后天性炎性肌病,相对罕见,发病率为每100万人中有9.3例。在我们的三级医疗风湿病服务中,每年800 - 1000名新患者中,通常会遇到1 - 2例皮肌炎患者。2020年4月至8月期间,发病率出现激增,这一时期恰逢孟买市冠状病毒(COVID - 19)大流行,在六个月的时间里共遇到5例病例。以下病例系列包括五例此类病例,并回顾了关于病毒引发自身免疫性的现有文献,特别提及了SARS-CoV-2以及此次大流行期间免疫抑制的挑战。