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新冠病毒感染后出现的寻常型口腔天疱疮:病例系列

The emerging concern of oral pemphigus vulgaris arising post-COVID-19 infection: A case series.

作者信息

Gunardi Indrayadi, Hartanto Firstine Kelsi, Amtha Rahmi, Nadiah Najla, Sari Elizabeth Fitriana

机构信息

Department of Oral Medicine, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia.

Dentistry and Oral Health Department, La Trobe University, Rural Health School, Australia.

出版信息

J Oral Maxillofac Pathol. 2023 Jul-Sep;27(3):557-561. doi: 10.4103/jomfp.jomfp_318_23. Epub 2023 Sep 12.


DOI:10.4103/jomfp.jomfp_318_23
PMID:38033962
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10683882/
Abstract

Cases of coronavirus disease 2019 (COVID-19) appear with a very diverse pattern of health manifestation, in which the immune system plays a major driver of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection outcomes. The uncontrolled immune response of SARS-CoV-2 infection could possibly lead to autoimmune diseases, as we observed increased cases of pemphigus vulgaris (PV) post-COVID-19 infection. PV is an autoimmune life-threatening mucocutaneous disease that is very rarely induced by certain drugs or substance. The link between COVID-19 infection and autoimmune diseases is still unknown. This study outline the possible link with PV following infection of COVID-19. A case series of three females and one male between the ages of 33 and 57 with no history of drug-induced illness or allergy were observed in our current case series. All patients previously contracted SARS-CoV-2. The lesions were treated with systemic and oral corticosteroid was given as a basic treatment for PV lesions. Immunomodulator agent was added as an adjunct to reduce the effects of steroid and to decrease the severity of PV. In conclusion, clinicians should be vigilant of the potential emergence of autoimmune reaction following the COVID-19 pandemic. Further investigation is required to unfold the unclear mechanism of PV induced by SARS-CoV-2. We hypothesized that the genetic aberrance inferred by this viral infection might trigger autoimmune diseases and may not limit to PV.

摘要

2019冠状病毒病(COVID-19)病例呈现出非常多样化的健康表现模式,其中免疫系统是严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染结果的主要驱动因素。正如我们在COVID-19感染后观察到寻常型天疱疮(PV)病例增加那样,SARS-CoV-2感染不受控制的免疫反应可能会导致自身免疫性疾病。PV是一种危及生命的自身免疫性黏膜皮肤疾病,很少由某些药物或物质诱发。COVID-19感染与自身免疫性疾病之间的联系仍然未知。本研究概述了COVID-19感染后与PV的可能联系。在我们当前的病例系列中,观察到3例女性和1例男性,年龄在33至57岁之间,无药物性疾病或过敏史。所有患者之前都感染过SARS-CoV-2。采用全身和口服皮质类固醇对病变进行治疗,作为PV病变的基本治疗方法。添加免疫调节剂作为辅助治疗,以减轻类固醇的作用并降低PV的严重程度。总之,临床医生应警惕COVID-19大流行后自身免疫反应的潜在出现。需要进一步调查以揭示SARS-CoV-2诱发PV的不明机制。我们假设这种病毒感染推断出的基因异常可能引发自身免疫性疾病,且可能不限于PV。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/872e/10683882/b9367afe1bff/JOMFP-27-557-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/872e/10683882/1dbc43bf42df/JOMFP-27-557-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/872e/10683882/b9367afe1bff/JOMFP-27-557-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/872e/10683882/1dbc43bf42df/JOMFP-27-557-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/872e/10683882/b9367afe1bff/JOMFP-27-557-g002.jpg

相似文献

[1]
The emerging concern of oral pemphigus vulgaris arising post-COVID-19 infection: A case series.

J Oral Maxillofac Pathol. 2023

[2]
Pemphigus Vulgaris After COVID-19: a Case of Induced Autoimmunity.

SN Compr Clin Med. 2021

[3]
Pemphigus vulgaris after SARS-CoV-2 vaccination: A case with new-onset and two cases with severe aggravation.

Dermatol Ther. 2022-5

[4]
Pemphigus Vulgaris Possibly Associated with COVID-19 Infection.

Cureus. 2023-1-17

[5]
Severe acute respiratory syndrome coronavirus 2 infection in patients with autoimmune bullous diseases in China.

J Dermatol. 2023-11

[6]
Rituximab as the treatment of pemphigus vulgaris in the COVID-19 pandemic era: A narrative review.

Dermatol Ther. 2021-1

[7]
Safety and Efficacy of Imatinib for Hospitalized Adults with COVID-19: A structured summary of a study protocol for a randomised controlled trial.

Trials. 2020-10-28

[8]
Autoimmune bullous disorder flares following severe acute respiratory syndrome coronavirus 2 vaccination: a case series.

J Med Case Rep. 2023-9-26

[9]
Diagnosis and Treatment Challenges of an Atypical Case of Pemphigus vulgaris During the COVID-19 Pandemic.

Cureus. 2022-1-30

[10]
Autoimmune skin disorders and SARS-CoV-2 vaccination - a meta-analysis.

J Dtsch Dermatol Ges. 2023-8

本文引用的文献

[1]
Management of oral mucositis: a systematic review.

Minerva Dent Oral Sci. 2023-10

[2]
Pemphigus Vulgaris Possibly Associated with COVID-19 Infection.

Cureus. 2023-1-17

[3]
Oral Lesions Associated with COVID-19 and the Participation of the Buccal Cavity as a Key Player for Establishment of Immunity against SARS-CoV-2.

Int J Environ Res Public Health. 2022-9-9

[4]
Pemphigus during the COVID-19 Epidemic: Infection Risk, Vaccine Responses and Management Strategies.

J Clin Med. 2022-7-8

[5]
Pemphigus vulgaris after COVID-19 infection and vaccination.

J Am Acad Dermatol. 2022-9

[6]
SARS-CoV-2 triggering autoimmune diseases.

Cytokine. 2022-6

[7]
New Onset of Autoimmune Diseases Following COVID-19 Diagnosis.

Cells. 2021-12-20

[8]
COVID-19 and Rheumatoid Arthritis Crosstalk: Emerging Association, Therapeutic Options and Challenges.

Cells. 2021-11-24

[9]
Satisfaction Level of the Oral Medicine Patients Using Teledentistry During the COVID-19 Pandemic: A Factor Analysis.

J Int Soc Prev Community Dent. 2021-7-30

[10]
Pemphigus Vulgaris After COVID-19: a Case of Induced Autoimmunity.

SN Compr Clin Med. 2021

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