Acute Exacerbation of Rheumatoid Arthritis Misdiagnosed as COVID-19: A Case Report
BackgroundRheumatoid arthritis (RA) is a systemic inflammatory connective tissue disease that affects 1–2% of the population worldwide. Pulmonary manifestations including interstitial lung disease (ILD), airway disease, pleural and vascular disease can be seen in up to 30–40% of patients with RA, wh...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.844609/full |
| _version_ | 1819320357642829824 |
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| author | Serife Torun Irem Karaman |
| author_facet | Serife Torun Irem Karaman |
| author_sort | Serife Torun |
| collection | DOAJ |
| description | BackgroundRheumatoid arthritis (RA) is a systemic inflammatory connective tissue disease that affects 1–2% of the population worldwide. Pulmonary manifestations including interstitial lung disease (ILD), airway disease, pleural and vascular disease can be seen in up to 30–40% of patients with RA, which are recognized as the second most frequent cause of death in RA patients. The simultaneous occurrence of COVID-19 in RA patients with or without ILD, and the similarities and differences between RA-related ILD and COVID-19 lung findings have been reported in the literature. However, there was no reported case on differentiation of clinical findings of a patient with RA exacerbation causing a new diagnosis of ILD during the pandemic conditions.Case PresentationHere, we presented a patient with RA who was misdiagnosed as COVID-19 twice due to non-specific respiratory symptoms and ground-glass opacities observed in high-resolution CT. The misdiagnosis led to a delayed diagnosis of ILD and prolonged pulmonary symptoms.DiscussionClinicians must critically review patients throughout the diagnostic workup by thinking other diseases besides COVID-19, particularly in the absence of a confirmatory result. The link between ILD or ILD exacerbation and COVID-19 remains to be determined. While research continues in the field, it is important to consider the importance of COVID-19 in cases of ILD exacerbation, and vice versa.ConclusionDistinguishing lung imaging findings of COVID-19 from ILD is a major concern. Even though the primary manifestation of COVID-19 consists of respiratory symptoms, clinicians should be vigilant for other common conditions having the same symptoms. Clinicians should carefully distinguish a differential diagnosis between COVID-19 and a flare of rheumatic disease. |
| first_indexed | 2024-12-24T11:18:18Z |
| format | Article |
| id | doaj.art-0906fd4231dc45f4a980b3ace2194761 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-24T11:18:18Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-0906fd4231dc45f4a980b3ace21947612022-12-21T16:58:19ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-03-01910.3389/fmed.2022.844609844609Acute Exacerbation of Rheumatoid Arthritis Misdiagnosed as COVID-19: A Case ReportSerife Torun0Irem Karaman1Department of Pulmonary Diseases, Konya Training and Research Hospital, Konya, TurkeySchool of Medicine, Bahcesehir University, Istanbul, TurkeyBackgroundRheumatoid arthritis (RA) is a systemic inflammatory connective tissue disease that affects 1–2% of the population worldwide. Pulmonary manifestations including interstitial lung disease (ILD), airway disease, pleural and vascular disease can be seen in up to 30–40% of patients with RA, which are recognized as the second most frequent cause of death in RA patients. The simultaneous occurrence of COVID-19 in RA patients with or without ILD, and the similarities and differences between RA-related ILD and COVID-19 lung findings have been reported in the literature. However, there was no reported case on differentiation of clinical findings of a patient with RA exacerbation causing a new diagnosis of ILD during the pandemic conditions.Case PresentationHere, we presented a patient with RA who was misdiagnosed as COVID-19 twice due to non-specific respiratory symptoms and ground-glass opacities observed in high-resolution CT. The misdiagnosis led to a delayed diagnosis of ILD and prolonged pulmonary symptoms.DiscussionClinicians must critically review patients throughout the diagnostic workup by thinking other diseases besides COVID-19, particularly in the absence of a confirmatory result. The link between ILD or ILD exacerbation and COVID-19 remains to be determined. While research continues in the field, it is important to consider the importance of COVID-19 in cases of ILD exacerbation, and vice versa.ConclusionDistinguishing lung imaging findings of COVID-19 from ILD is a major concern. Even though the primary manifestation of COVID-19 consists of respiratory symptoms, clinicians should be vigilant for other common conditions having the same symptoms. Clinicians should carefully distinguish a differential diagnosis between COVID-19 and a flare of rheumatic disease.https://www.frontiersin.org/articles/10.3389/fmed.2022.844609/fullrheumatoid arthritisinterstitial lung diseaseCOVID-19diagnosismisdiagnosis |
| spellingShingle | Serife Torun Irem Karaman Acute Exacerbation of Rheumatoid Arthritis Misdiagnosed as COVID-19: A Case Report Frontiers in Medicine rheumatoid arthritis interstitial lung disease COVID-19 diagnosis misdiagnosis |
| title | Acute Exacerbation of Rheumatoid Arthritis Misdiagnosed as COVID-19: A Case Report |
| title_full | Acute Exacerbation of Rheumatoid Arthritis Misdiagnosed as COVID-19: A Case Report |
| title_fullStr | Acute Exacerbation of Rheumatoid Arthritis Misdiagnosed as COVID-19: A Case Report |
| title_full_unstemmed | Acute Exacerbation of Rheumatoid Arthritis Misdiagnosed as COVID-19: A Case Report |
| title_short | Acute Exacerbation of Rheumatoid Arthritis Misdiagnosed as COVID-19: A Case Report |
| title_sort | acute exacerbation of rheumatoid arthritis misdiagnosed as covid 19 a case report |
| topic | rheumatoid arthritis interstitial lung disease COVID-19 diagnosis misdiagnosis |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.844609/full |
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