Gunardi Indrayadi, Hartanto Firstine Kelsi, Amtha Rahmi, Nadiah Najla, Sari Elizabeth Fitriana
Department of Oral Medicine, Faculty of Dentistry, Universitas Trisakti, Jakarta, Indonesia.
Dentistry and Oral Health Department, La Trobe University, Rural Health School, Australia.
J Oral Maxillofac Pathol. 2023 Jul-Sep;27(3):557-561. doi: 10.4103/jomfp.jomfp_318_23. Epub 2023 Sep 12.
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.
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。
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