A Case of Autoimmune Small Fiber Neuropathy as Possible Post COVID Sequelae

Noel G. Panagiotides, Fritz Zimprich, Klaus Machold, Oliver Schlager, Markus Müller, Sebastian Ertl, Henriette Löffler-Stastka, Renate Koppensteiner and Patricia P. Wadowski ()
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Noel G. Panagiotides: Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria
Fritz Zimprich: Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria
Klaus Machold: Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, 1090 Vienna, Austria
Oliver Schlager: Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria
Markus Müller: Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria
Sebastian Ertl: Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria
Henriette Löffler-Stastka: Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria
Renate Koppensteiner: Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria
Patricia P. Wadowski: Division of Angiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria

IJERPH, 2023, vol. 20, issue 6, 1-12

Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is reported to induce and augment autoimmune processes. Moreover, postinfectious effects of coronavirus disease 2019 (COVID-19) are still poorly understood and often resemble symptoms of the acute infection phase. A patient with swollen extremities was presented to the Department of Angiology at the Medical University of Vienna with complaints of muscle and joint pain, paresthesia, and arterial hypertension with intense headache. Prior to these complaints, she had been suffering from various symptoms since November 2020, following a SARS-CoV-2 infection in the same month. These included recurrent sore throat, heartburn, dizziness, and headache. Paresthesia and muscle and joint pain started in temporal relation to a human papillomavirus (HPV) vaccination. Since the patient was suffering from severe pain, intensive pain management was performed. Skin and nerve biopsies revealed autoimmune small fiber neuropathy. The patient’s condition could be related to COVID-19, as her first symptoms began in temporal relation to the SARS-CoV-2 infection. Furthermore, in the disease course, antinuclear (ANA) and anti-Ro antibodies, as well as anti-cyclic citrullinated peptide (anti-CCP) antibodies, could be detected. Together with the symptoms of xerophthalmia and pharyngeal dryness, primary Sjögren’s syndrome was diagnosed. In conclusion, though biopsy results could not distinguish a cause of the disease, SARS-CoV-2 infection can be discussed as a likely trigger for the patient’s autoimmune reactions.

Keywords: autoimmune small fiber neuropathy; SARS-CoV-2; long COVID; primary Sjögren’s syndrome (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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