A rare subset of Coronavirus Disease-2019 (COVID-19) positive patients has musculoskeletal manifestations including arthritis, arthralgia, myalgia and non specific body aches. Moreover, postviral Reactive Arthritis (ReA) has been reported following COVID-19 infection. This article reports the characteristic joint manifestations of Severe Acute Respiratory Syndrome-Corona Virus-2 (SARSCoV-2) infection in 6 out of 211 consecutive patients with laboratory-confirmed diagnosis of COVID-19 and treated at dedicated hospital. One 49-year-old female patient developed arthritis while having active COVID-19 infection, one 54-year-old male had post-COVID-19 ReA, and one 48-year-old female was found to have undifferentiated arthritis. One 58-year-old female patient was initially thought to have ReA the diagnosis was reconsidered later when her symptoms resolved without any disease modifying agents. Two patients 37-year-old male and 63-year-old female, developed arthralgia following COVID-19 infection. Non Steroidal Anti-Inflammatory Drugs (NSAIDs) and steroids were found to be beneficial in the series of patients. The key point to be noted is that not all arthritis or arthralgia following COVID-19 is ReA.

Background: While many factors are known to play a role in outcomes of sepsis, the role of micronutrients such as zinc remains a gray area. This study assesses the correlation of plasma zinc levels with mortality and severity of sepsis. Objective was to study the association between plasma zinc levels with mortality and severity of sepsis.Methods: Comparative prospective observational study which included 89 patients with proven sepsis according to the society of critical care medicine (SCCM) guidelines. The study was conducted at a tertiary care centre in South India. A total of 89 patients who were admitted into the medical ICU directly from ER, from December 2014 to August 2015 were chosen for the study after satisfying specific inclusion criteria and divided into 2 outcome groups based on mortality.Results: There was a significant association between plasma zinc (categorized as low, normal and high plasma zinc) and outcome. While the severity of sepsis as per SOFA score on admission did not have an association, there was a significant association between plasma zinc and the 48-hour SOFA score.Conclusions: Higher plasma zinc values had lower mortality and lower 48 hours SOFA score, strengthening the hypothesis regarding the role of zinc in the immune response to sepsis. More research is needed regarding the role of zinc in assessing the severity and predicting the mortality of patients with sepsis.

We present a case of hemophagocytic lymphocytosis (HLH) that occurred secondary to a combination of Epstein Barr virus (EBV) infection and systemic lupus erythematosus (SLE) in early pregnancy. A 29-years-old lady presented with complaints of fever, vomiting and loose stools. She underwent successful in-vitro fertilization (IVF) and embryo transfer 20 days prior to the onset of these symptoms. Her blood investigations revealed anemia, neutropenia, hyperferritinemia and hypertriglyceridemia, eventually resulting in a diagnosis of HLH further substantiated by bone marrow examination. Additional investigations revealed positive anti-dsDNA and EBV IgM antibodies amongst other findings, adding SLE and EBV to the diagnoses. They were considered potential triggers for HLH. However, the occurrence of these events following IVF poses the question of whether pregnancy played a role in the development of HLH. Our patient responded well to pulse steroid therapy and has had an uneventful course till date.

Introduction. There is a scarcity of information available on clinical and laboratory features of adult-onset idiopathic autoimmune uveitis. Therefore, we conducted a single centre descriptive cross-sectional study. Patients and Methods. A chart review of all patients with idiopathic autoimmune uveitis with onset after 18 years of age who were referred to the rheumatology department between January 2017 and December 2018 was performed. Their clinical features, demographic features, and HLA-B genotypes were documented and described. Results. Out of 210 patients referred to rheumatology, 66 were found to have uveitis, and 16 of these had an adult-onset idiopathic autoimmune uveitis. Apart from a slight female preponderance (62.5%), our patients were characterized by a high proportion of panuveitis (4 out of 16, i.e., 25%). There was an increased frequency of occurrence of synechiae (5 out of 16, i.e., 31.3%), retinal vasculitis (4 out of 16, i.e., 25%), optic disc edema (3 out of 16, i.e., 18.8%), and cystoid macular edema (seen in 2 patients, i.e., 12.5%). These features correlated with the anatomical subtypes. Retinal vasculitis and optic disc edema present in three fourth of all panuveitis cases were the most prominent features. The odds of finding HLA-B∗35 in retinal vasculitis were 33 times higher than odds of finding it in idiopathic autoimmune uveitis patients not having retinal vasculitis (OR 33; 95% CI 1.6–698). Conclusion. Idiopathic autoimmune uveitis in our patients is characterized by a high frequency of panuveitis and retinal vasculitis, and complications with a probable association between HLA-B∗35 and retinal vasculitis.