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参考文献
inflammation1)4)8)9). These mechanisms are consistent with the CT imaging in our case, which
showed strong perivascular inflammation around
the thrombosis in the lower limb (Fig. 2).
Although the mechanisms of cutaneous manifestations of COVID-19 is not yet well documented, some theories suggest a relation to host
immunity. Viral particles present in the cutaneous
blood cause vasculitis, and the immune response
leads to Langerhans cell activation, which results
in a state of vasodilation and spongiosis that
causes cutaneous disturbances6). A pathological
study revealed colocalization of SARS-CoV-2specific spike proteins with complements in the
lung and skin tissue4).
There are two limitations to our confirmation of
1)
Connors JM and Levy JH : Thromboinflammation and the hypercoagulability of COVID-19. J
Thromb Haemost 18 : 1559-1561, 2020.
2) Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J,
Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li
Y, Wang X and Peng Z : Clinical Characteristics
of 138 Hospitalized Patients with 2019 Novel
Coronavirus-Infected Pneumonia in Wuhan,
China. JAMA-J Am Med Assoc 323 : 10611069, 2020.
3) Campbell CM and Kahwash R : Will Complement Inhibition be the New Target in Treating
COVID-19 Related Systemic Thrombosis? Circulation 141 : 1739-1741, 2020.
4) Magro C, Mulvey JJ, Berlin D, Nuovo G,
Salvatore S, Harp J, Baxter-Stoltzfus A and
Laurence J : Complement associated microvascular injury and thrombosis in the
COVID-19 complications and host immunity
pathogenesis of severe COVID-19 infection : A
report of five cases. Transl Res 220 : 1-13, 2020.
5) Felsenstein S, Herbert JA, McNamara PS and
Hedrich CM : COVID-19 : Immunology and
treatment options. Clin Immunol 215 : 108448,
2020.
6) Sachdeva M, Gianotti R, Shah M, Bradanini L,
Tosi D, Veraldi S, Ziv M, Leshem E and DodiukGad RP : Cutaneous manifestations of COVID19 : Report of three cases and a review of
literature. J Dermatol Sci 98 : 75-81, 2020.
7) Bilaloglu S, Aphinyanaphongs Y, Jones S,
Iturrate E, Hochman J, Berger JS : Thrombosis
in Hospitalized Patients With COVID-19 in a
New York City Health System. JAMA 324 :
799-801, 2020.
8)
141
Ranucci M, Ballotta A, Di Dedda U, Bayshnikova
E, Dei Poli M, Resta M, Falco M, Albano G and
Menicanti L : The procoagulant pattern of
patients with COVID-19 acute respiratory
distress syndrome. J Thromb Haemost 18 :
1747-1751, 2020.
9) Panigada M, Bottino N, Tagliabue P, Grasselli G,
Novembrino C, Chantarangkul V, Pesenti A,
Peyvandi F and Tripodi A : Hypercoagulability
of COVID-19 patients in Intensive Care Unit. A
Report of Thromboelastography Findings and
other Parameters of Hemostasis. J Thromb
Haemost 18 : 1738-1742, 2020.
(Received for publication August 18, 2020)
142
N. Tani et al.
(和文抄録)
IgG 陽転化の時期と一致して皮疹,深部静脈血栓症,肺塞栓症を合併した,
新型コロナウイルス感染症の軽症例
1)
九州大学大学院医学研究院 病態修復内科(第一内科)
2)
福岡市民病院 感染症内科
3)
福岡市民病院 COVID-19 対策班
4)
九州大学病院 グローバル感染症センター
直 樹1)3),南
順 也2),三 宅 典 子1)3),権 藤
圭3),井 上
健1)3),
斧 沢 京 子2),柳田雄一郎3),小 野 雄 一3),齊 藤 太 一3),平 川 勝 之3),
湧1),下 野 信 行1)4),桑 野 博 行3)
秀 史3),º
新型コロナウイルス感染症(COVID-19)は,症状増悪や合併症が発症から遅れて出現することが
知られており,そのメカニズムは自己免疫が介在している可能性が報告されている.ここに,軽症の
COVID-19 に肺塞栓症(PE)と深部静脈血栓症(DVT)を合併した症例を報告する.38 歳の生来健康
な男性患者が,day 1 に発熱,咳嗽,呼吸困難を呈し,day 2 に採取した鼻咽頭スワブによる PCR で新
型コロナウイルス(SARS-CoV-2)RNA が陽性であったため,COVID-19 と診断された.酸素投与や
特異的治療を要することなく自然解熱したものの,day 9 に四肢に発疹が出現し,day 10 に右腓腹部
の疼痛を認めた.造影 CT にて PE と DVT が確認された.発疹は自然消失し,腓腹部痛は rivaroxaban 投与後に改善した.day 13,15 に PCR 陰性化を確認した.残存血清を用いて血清 IgG と IgM
を測定したところ,合併症の出現時期はウイルスクリアランスと IgG seroconversion と一致した.本
患者の臨床経過は,COVID-19 の合併症の中には宿主免疫によって引き起こされるものがあるという
仮説を支持するものであった.
キーワード:COVID-19,SARS-CoV-2,IgG セロコンバージョン,肺塞栓症,深部静脈血栓症
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