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Abstract
Case Report
A case of coronavirus disease 2019 needs to be differentiated from pulmonary complications of graft versus host disease
Ryosuke Morioa Takahiro Takazonoa,b Nobuyuki Ashizawaa,c Kazuko Yamamotoa Koichi Izumikawab,c Hiroshi Mukaea
aDepartment of Respiratory Medicine, Nagasaki University Hospital
bDepartment of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences
cInfection Control and Education Center, Nagasaki University Hospital
ABSTRACT
A 64-year-old man who had undergone an allogeneic hematopoietic stem cell transplantation due to acute myeloid leukemia presented with dyspnea lasting for 18 days. Chest computed tomography showed bilateral patchy consolidations and ground-glass opacities. At first, we suspected pulmonary complications of graft versus host disease (GVHD), as he had been diagnosed with chronic gastrointestinal and dermal GVHD. SARS-CoV-2 antigen and polymerase chain reaction tests showed negative results. However, serologic antibody testing of SARS-CoV-2 nucleocapsid (N) protein proved positive, and we clinically diagnosed coronavirus disease 2019 (COVID-19). In cases with COVID-19 symptoms which last for over 2 weeks, SARS-CoV-2 N antibody tests can be useful. In this COVID-19 era, we should consider COIVD-19 as one of the differential diagnoses when a patient shows interstitial shadows, even if the SARS-CoV-2 PCR test is negative.
KEYWORDS
Allogeneic hematopoietic stem cell transplantation Graft versus host disease (GVHD) Coronavirus disease 2019 (COVID-19) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) SARS-CoV-2 N antibody test
Received 31 Jan 2022 ／ Accepted 6 Jun 2022
AJRS, 11(5): 296-300, 2022
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