Aseptic Abscess Syndrome in Rheumatoid Arthritis Patient

Aseptic abscess syndrome (AAS) is a rare, potentially life-threatening disorder, with numerous features of neutrophilic dermatoses. The main symptoms include aseptic abscess-like collections in internal organs (spleen, liver, lungs), lack of microbes (bacteria, viruses, or parasites) after an exhaus...

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Main Authors: Agnieszka Owczarczyk-Saczonek, Marta Kasprowicz-Furmańczyk, Jakub Kuna, Paulina Klimek, Magdalena Krajewska-Włodarczyk
Format: Article
Language:English
Published: MDPI AG 2022-09-01
Series:Medicina
Subjects:
Online Access:https://www.mdpi.com/1648-9144/58/10/1354
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author Agnieszka Owczarczyk-Saczonek
Marta Kasprowicz-Furmańczyk
Jakub Kuna
Paulina Klimek
Magdalena Krajewska-Włodarczyk
author_facet Agnieszka Owczarczyk-Saczonek
Marta Kasprowicz-Furmańczyk
Jakub Kuna
Paulina Klimek
Magdalena Krajewska-Włodarczyk
author_sort Agnieszka Owczarczyk-Saczonek
collection DOAJ
description Aseptic abscess syndrome (AAS) is a rare, potentially life-threatening disorder, with numerous features of neutrophilic dermatoses. The main symptoms include aseptic abscess-like collections in internal organs (spleen, liver, lungs), lack of microbes (bacteria, viruses, or parasites) after an exhaustive search, ineffectiveness of antibiotics, and high sensitivity to corticosteroid therapy. AAS is characterized by the development of deep, inflammatory abscesses and systemic symptoms (weight loss, abdominal pain, fever, and leukocytosis). They may be associated with inflammatory bowel disease (IBD) and autoimmune diseases. The patient in this study is a 67-year-old man, suffering from rheumatoid arthritis (RA), with numerous purulent abscesses in the mediastinum, within the subcutaneous tissue above the extension surfaces of the joints, and on the dorsum of the hands. The lesions are accompanied by bone destruction. The patient was treated with prednisone 40 mg and adalimumab, which resulted in a quick reduction of inflammatory markers and clinical improvement, as well as the healing and absorption of abscesses. Despite COVID-19 infection, treatment with remdesivir, prednisone, and adalimumab was continued, with the complete resolution of the lesions. AAS is difficult to recognize, so practitioners have to be aware of this condition, especially in patients with RA.
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spelling doaj.art-93ed6166954a41ceb6b1b8c88d38f5712023-11-24T01:09:41ZengMDPI AGMedicina1010-660X1648-91442022-09-015810135410.3390/medicina58101354Aseptic Abscess Syndrome in Rheumatoid Arthritis PatientAgnieszka Owczarczyk-Saczonek0Marta Kasprowicz-Furmańczyk1Jakub Kuna2Paulina Klimek3Magdalena Krajewska-Włodarczyk4Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, School of Medicine, Collegium Medicum, The University of Warmia and Mazury, Al. Wojska Polskiego 30, 10-229 Olsztyn, PolandDepartment of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, School of Medicine, Collegium Medicum, The University of Warmia and Mazury, Al. Wojska Polskiego 30, 10-229 Olsztyn, PolandDepartment of Rheumatology, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-900 Olsztyn, PolandDepartment of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, School of Medicine, Collegium Medicum, The University of Warmia and Mazury, Al. Wojska Polskiego 30, 10-229 Olsztyn, PolandDepartment of Rheumatology, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-900 Olsztyn, PolandAseptic abscess syndrome (AAS) is a rare, potentially life-threatening disorder, with numerous features of neutrophilic dermatoses. The main symptoms include aseptic abscess-like collections in internal organs (spleen, liver, lungs), lack of microbes (bacteria, viruses, or parasites) after an exhaustive search, ineffectiveness of antibiotics, and high sensitivity to corticosteroid therapy. AAS is characterized by the development of deep, inflammatory abscesses and systemic symptoms (weight loss, abdominal pain, fever, and leukocytosis). They may be associated with inflammatory bowel disease (IBD) and autoimmune diseases. The patient in this study is a 67-year-old man, suffering from rheumatoid arthritis (RA), with numerous purulent abscesses in the mediastinum, within the subcutaneous tissue above the extension surfaces of the joints, and on the dorsum of the hands. The lesions are accompanied by bone destruction. The patient was treated with prednisone 40 mg and adalimumab, which resulted in a quick reduction of inflammatory markers and clinical improvement, as well as the healing and absorption of abscesses. Despite COVID-19 infection, treatment with remdesivir, prednisone, and adalimumab was continued, with the complete resolution of the lesions. AAS is difficult to recognize, so practitioners have to be aware of this condition, especially in patients with RA.https://www.mdpi.com/1648-9144/58/10/1354aseptic abscess syndromerheumatoid arthritisadalimumab
spellingShingle Agnieszka Owczarczyk-Saczonek
Marta Kasprowicz-Furmańczyk
Jakub Kuna
Paulina Klimek
Magdalena Krajewska-Włodarczyk
Aseptic Abscess Syndrome in Rheumatoid Arthritis Patient
Medicina
aseptic abscess syndrome
rheumatoid arthritis
adalimumab
title Aseptic Abscess Syndrome in Rheumatoid Arthritis Patient
title_full Aseptic Abscess Syndrome in Rheumatoid Arthritis Patient
title_fullStr Aseptic Abscess Syndrome in Rheumatoid Arthritis Patient
title_full_unstemmed Aseptic Abscess Syndrome in Rheumatoid Arthritis Patient
title_short Aseptic Abscess Syndrome in Rheumatoid Arthritis Patient
title_sort aseptic abscess syndrome in rheumatoid arthritis patient
topic aseptic abscess syndrome
rheumatoid arthritis
adalimumab
url https://www.mdpi.com/1648-9144/58/10/1354
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