Sadeghi Amir, Dooghaie Moghadam Arash, Eslami Pegah, Pirsalehi Ali, Salari Sina, Roshandel Elham
Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Assistant Professor of Medical Oncology, Hematology and Bone Marrow Transplantation; Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Gastroenterol Hepatol Bed Bench. 2020 Fall;13(4):400-404.
Today, COVID-19 pneumonia causes global concern. The World Health Organization (WHO) has reported many mortalities from this disease all around the world. Therefore, recognizing new cases of COVID-19 is crucial during this pandemic. Many studies have shown that COVID-19 has a broad spectrum of signs and symptoms, including GI and cutaneous manifestations. Previous studies have reported liver enzyme changes as well as diarrhea as a common GI manifestation of COVID-19. However, there are few reports about COVID-19 synchronous cutaneous and liver involvement. Additionally, there are few reports about intrahepatic cholestasis in COVID-19 patients. In this article, a confirmed case of COVID-19 with vasculopathy-related cutaneous manifestation and liver cholestasis is reported. A 67-year-old Iranian woman was admitted to Taleghani Hospital with epigastric pain, vomiting, anosmia, rising liver enzyme levels, fever, itching, and skin rashes. Skin and liver biopsies were performed during the patient's admission; the results suggested vasculopathy-related cutaneous lesion and liver cholestasis. Plasmapheresis was initiated and all manifestations disappeared after treatment. All atypical presentations, including cutaneous lesions and liver manifestations, should be considered as COVID-19 and evaluated.
如今，新型冠状病毒肺炎引起了全球关注。世界卫生组织（WHO）已报告全球范围内该疾病导致的众多死亡病例。因此，在此次大流行期间识别新型冠状病毒肺炎的新病例至关重要。许多研究表明，新型冠状病毒肺炎有广泛的体征和症状，包括胃肠道和皮肤表现。先前的研究报告了肝酶变化以及腹泻是新型冠状病毒肺炎常见的胃肠道表现。然而，关于新型冠状病毒肺炎同时累及皮肤和肝脏的报道较少。此外，关于新型冠状病毒肺炎患者肝内胆汁淤积的报道也很少。本文报告了一例确诊的新型冠状病毒肺炎病例，该病例伴有血管病变相关的皮肤表现和肝内胆汁淤积。一名67岁的伊朗女性因上腹部疼痛、呕吐、嗅觉丧失、肝酶水平升高、发热、瘙痒和皮疹入住塔莱哈尼医院。患者住院期间进行了皮肤和肝脏活检；结果提示血管病变相关的皮肤病变和肝内胆汁淤积。开始进行血浆置换，治疗后所有症状均消失。所有非典型表现，包括皮肤病变和肝脏表现，都应考虑为新型冠状病毒肺炎并进行评估。
