Multicentric reticulohistiocytosis post-COVID-19: a case report.

IF 0.7 Q3 MEDICINE, GENERAL & INTERNAL AME Case Reports Pub Date : 2024-03-08 eCollection Date: 2024-01-01 DOI:10.21037/acr-23-144
Young Min Cho, Sarah V Ross, Riaz Mahmood, Marta T Bognar
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Abstract

Background: Multicentric reticulohistiocytosis (MRH) stands as a rare and challenging systemic granulomatous disease characterized by its predilection for skin and joint involvement, confounding clinicians with its infrequent presentation and systemic manifestations.

Case description: This compelling case presentation unravels the intricate complexity of MRH, exemplifying its unique clinical course. Following mild upper respiratory coronavirus disease 2019 (COVID-19) symptoms, the patient manifested purplish-pink papular lesions on both the skin and mucosa, accompanied by debilitating arthralgias. A diagnostic skin biopsy, a pivotal tool in MRH diagnosis, confirmed the presence of this granulomatous disorder, underlining its systemic impact. Strategic therapeutic intervention involving a combination of steroids and methotrexate demonstrated remarkable efficacy, culminating in the resolution of symptoms within 3-month. The absence of malignancy upon thorough screening further amplifies the perplexing nature of MRH.

Conclusions: This seminal case not only bridges the realms of rare systemic disorders but also marks the first known instance of MRH emerging post-COVID-19. It underscores the imperative consideration of MRH in analogous scenarios and provides invaluable insights into the nuanced interplay of MRH symptoms, diagnosis, and therapeutic strategies following viral triggers. This comprehensive exploration enriches our scientific understanding, offering nuanced perspectives on the manifestations and intricate dynamics of MRH in the context of post-viral sequelae.

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COVID-19后多中心网状组织细胞增多症:病例报告。
背景:多中心网状组织细胞增生症(MRH)是一种罕见且具有挑战性的系统性肉芽肿病,其特点是易累及皮肤和关节,临床医生对其罕见的表现和全身性表现感到困惑:这个引人注目的病例揭示了 MRH 的复杂性,体现了其独特的临床过程。患者在出现轻微的上呼吸道冠状病毒病 2019(COVID-19)症状后,皮肤和粘膜出现紫粉色丘疹性病变,并伴有衰弱性关节痛。诊断性皮肤活检是 MRH 诊断的关键工具,它证实了这种肉芽肿性疾病的存在,强调了其全身性影响。结合使用类固醇和甲氨蝶呤的策略性治疗效果显著,最终在三个月内症状得到缓解。经全面检查未发现恶性肿瘤,这进一步凸显了 MRH 的复杂性:这个具有开创性意义的病例不仅在罕见系统性疾病领域架起了一座桥梁,而且也是 COVID-19 后出现的第一个 MRH 病例。它强调了在类似情况下考虑 MRH 的必要性,并就病毒触发后 MRH 症状、诊断和治疗策略的微妙相互作用提供了宝贵的见解。这一全面探讨丰富了我们的科学认识,为病毒后遗症背景下 MRH 的表现和复杂动态提供了细致入微的视角。
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