Case report: Unusual patient with dermatomyositis associated with SARS-CoV-2 infection

Joanna Niedzielska; Monika Chaszczewska-Markowska; Justyna Chojdak-Łukasiewicz; Jakub Berezowski; Seema Kalra; Przemysław Jazwiec

doi:10.3389/fneur.2023.1122475

Case report: Unusual patient with dermatomyositis associated with SARS-CoV-2 infection

Front Neurol. 2023 May 19:14:1122475. doi: 10.3389/fneur.2023.1122475. eCollection 2023.

Authors

Joanna Niedzielska¹, Monika Chaszczewska-Markowska², Justyna Chojdak-Łukasiewicz³, Jakub Berezowski⁴, Seema Kalra⁵, Przemysław Jazwiec⁶

Affiliations

¹ Department of Neurology, Specialist Medical Center in Polanica Zdrój, Polanica-Zdrój, Poland.
² Laboratory of Clinical Immunogenetics and Pharmacogenetics, Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland.
³ Department of Neurology, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland.
⁴ Department of Administration, Jan Mikulicz Radecki University Teaching Hospital in Wroclaw, Wroclaw, Poland.
⁵ Department of Neurology, Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom.
⁶ Department of Imaging Diagnostics, Specialist Medical Center in Polanica Zdrój, Polanica-Zdrój, Poland.

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak is a major challenge for clinicians. SARS-CoV-2 infection results in coronavirus disease 2019 (COVID-19), and it is best known for its respiratory symptoms. It can also result in several extrapulmonary manifestations such as neurological complications potentially experienced during the course of COVID-19. The association of dermatomyositis (DM) with COVID-19 pathogenesis has not been well-studied. This study aimed to present a previously healthy 37-year-old man, a soldier by profession, with symptoms of DM on the 4th day from the onset of COVID-19. The patient presented DM symptoms with both skin and muscle manifestations. The patient suffered from cough, fever, and fatigue to begin with, and reverse-transcription polymerase chain reaction (RT-PCR) reported positive for SARS-CoV-2 infection. The laboratory findings showed, intra alia, elevated muscle enzymes CK 8253 U/l (N: <145 U/l), a positive test for myositis-specific autoantibodies (anti-Mi-2), electrodiagnostic tests exhibited features of myopathy, with the presence of muscle and skin symptoms. The patient improved with corticosteroids and immunosuppressive agent therapy. In summary, the association between COVID-19 and the development of multi-system autoimmune disorders such as DM remains unclear. Nevertheless, viral infections such as SARS-CoV-2 may likely serve as a trigger.

Keywords: COVID-19; SARS-CoV-2; dermatomyositis; extrapulmonary manifestation; neurological complication.

Publication types

Case Reports

Grants and funding

The article processing charge was funded by the Ministry of Science and Higher Education of Poland under the statutory subvention of the Wroclaw Medical University.