CRCM  Vol.11 No.9 , September 2022
COVID-19 Induced Mixed Connective Tissue Disease (MCTD)—Case Report
Abstract: Mixed connective tissue disease (MCTD) is a rare systemic autoimmune disorder that damages multiple organs simultaneously and is associated with chronic inflammation, in which the signs of systemic sclerosis, systemic lupus erythematosus, and polymyositis can co-occur. Its distinctive feature and the basis for the diagnosis of MCTD is the presence of an antibody against the uridine-rich RNP of the cell nucleus (Anti-U1-RNP). It has been observed that intercurrent infections can trigger autoimmune diseases, however, the fact that viral infections—such as SARS-CoV-2—induce them is currently poorly understood. The present study raises the etiological role of the SARS-CoV-2 virus in the development of the disease. Authors describe the case of a 38-year-old patient in good general condition, who was diagnosed with mixed connective tissue disease three months after COVID-19 infection.
Cite this paper: Nagy-Kardos, C. , Zöld, D. , Tihanyi, L. and Veress, G. (2022) COVID-19 Induced Mixed Connective Tissue Disease (MCTD)—Case Report. Case Reports in Clinical Medicine, 11, 393-398. doi: 10.4236/crcm.2022.119055.

[1]   Sharp, G.C., Irvin, W.S., Tan, E.M., et al. (1972) Mixed Connective Tissue Disease—An Apparently Distinct Rheumatic Disease Syndrome Associated with a Specific Antibody to An Extractable Nuclear Antigen (ENA). The American Journal of Medicine, Clinical Study, 52, 148-159.

[2]   WHO (2021) Coronavirus Disease (COVID-19): Post COVID-19 Condition.

[3]   Lyubomir, D., Dimitrina, G., Joana, P., et al. (2021) Autoimmune Connective Tissue Diseases in the COVID-19 Pandemic. Clinics in Dermatology, 39, 56-63.

[4]   Sajjad, A., Talal, A., Ujala, Z., et al. (2022) A Novel Case of Lupus Nephritis and Mixed Connective Tissue Disorder in a COVID-19 Patient. Annals of Medicine and Surgery, 78, Article ID: 103653.

[5]   Joo, Y.B., Lim, Y.H., Kim, K.J., et al. (2019) Respiratory Viral Infections and the Risk of Rheumatoid Arthritis. Arthritis Research & Therapy, 21, Article No. 199.

[6]   Karsulovic, C., Hojman, L.P., Seelmann, D.L., et al. (2021) Diffuse Lymphadenopathy Syndrome as a Flare-Up Manifestation in Lupus and Mixed Connective Tissue Disease Following Mild COVID-19. American Journal of Case Reports, 22, Article ID: e932751.

[7]   Bahramnezhad, F., Ghorbani, B., Ghaedrahamt, M., et al. (2021) Coronavirus-Disease-2019-Induced Antiphospholipid-Like Syndrome: A Case Report. Journal of Medical Case Reports, 15, Article No. 408.

[8]   Zamani, B., Moeini Taba, S.M. and Shayestehpour, M. (2021) Systemic Lupus Erythematosus Manifestation Following COVID-19: A Case Report. Journal of Medical Case Reports, 15, Article No. 29.

[9]   Bonometti, R., Sacchi, M.C., Stobbione, P., et al. (2020) The First Case of Systemic Lupus Erythematosus (SLE) Triggered by COVID-19 Infection. European Review for Medical and Pharmacological Sciences, 24, 9695-9697.

[10]   Alarcon-Segovia, D. and Villarreal, M. (1987) Classification and Diagnostic Criteria for Mixed Connective Tissue Disease. In: Kasukawa, R., Sharp, G.C., et al., Eds., Mixed Connective Tissue Disease and Anti-Nuclear Antibodies, Elsevier Science, Amsterdam, 33-40.

[11]   Greidinger, E.L. and Hoffman, R.W. (2005) Autoantibodies in the Pathogenesis of Mixed Connective Tissue Disease. Rheumatic Disease Clinics, 31, 437-450.

[12]   Hajas, á., Csípő, I., Dezső, B., et al. (2011) Fenotípusok kevert kötőszöveti bete-gségekben. Bőrgyógyászati és venerológiai Szemle, 87, 79-83.

[13]   Kórlefolyás, H.á. (2013) Prognózis és fenotípusok kevert kötőszöveti betegségben. PhD értekezés. Debreceni Egyetem, Petrányi Gyula Klinikai Immunológiai és Aller-gológiai Doktori Iskola.

[14]   Sharp, G.C. and Anderson, P.C. (1980) Current Concepts in the Classification of Connective Tissue Diseases. Overlap Syndromes and Mixed Connective Tissue Disease (MCTD). Journal of the American Academy of Dermatology, 2, 269-279.

[15]   Sullivan, W.D., Hurst, D.J., Harmon, C.E., et al. (1984) A Prospective Evaluation Emphasizing Pulmonary Involvement in Patients with Mixed Connective Tissue Disease. Medicine, 63, 92-107.

[16]   Singsen, B.H., Swanson, V.L., Bernstein, B.H., et al. (1980) A Histologic Evaluation of Mixed Connective Tissue Disease in Childhood. The American Journal of Medicine, 68, 710-717.

[17]   Végh, J., Csípő, I., Udvardy, M., et al. (2006) A pulmonális artériás hipertenzió kórlefolyása, klinikai és immunszerológiai jellemzői kevert kötőszöveti betegségben. Magyar Immunológia, 5, 37-48.

[18]   Kozuka, T., Johkoh, T., Honda, O., et al. (2001) Pulmonary Involvement in Mixed Connective Tissue Disease: High-Resolution CT Findings in 41 Patients. Journal of Thoracic Imaging, 16, 94-98.

[19]   Grader-Beck, T. and Wigley, F.M. (2005) Raynaud’s Phenomenon in Mixed Connective Tissue Disease. Rheumatic Disease Clinics of North America, 31, 465-481.