A 47-year-old woman presented with a 2-month history of generalized arthralgia and a 10-day history of oral aphthous ulcers. After hospitalization, papulopustular lesions and perianal ulcerations developed. Pathergy test was positive and ophthalmological examination was normal. The presence of oral aphthous ulcers, genital ulcerations, papulopustular lesions and arthralgia, and the positive pathergy test suggested the diagnosis of Behçet's disease (BD). In a few days, positive pathergy reactions and papulopustular lesions evolved into bullous lesions, which were diagnosed dermatopathologically as pyoderma gangrenosum. Two days after the presentation of papulopustular lesions, the patient experienced diarrhoea accompanied by bloody stools and mucus. Histopathological examination of biopsy specimens showed no vasculitis but revealed findings suggestive of Crohn's disease. The patient responded well to treatment with systemic steroids and 5-aminosalicylic acid. Our case demonstrates that the differential diagnosis of BD and inflammatory bowel disease may be perplexing and that these two diseases may be closely related.

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Background In COVID-19, severe disease course such as need of intensive care unit (ICU) as well as development of mortality is mainly due to cytokine storm. In this study, we aimed to evaluate the high-dose intravenous anakinra treatment response and outcome in patients with severe and critically ill COVID-19 compared to standard of care. Methods This retrospective observational study was carried out at a tertiary referral center. The study population consisted of two groups as follows: the patients receiving high-dose intravenous anakinra (anakinra group) between 01.09.2021 and 01.02.2022 and the patients treated with standard of care (SoC, control group) as historical control group who were hospitalized between 01.07.2021 and 01.09.2021. Results After the propensity score 1:1 matching, 79 patients in anakinra and 79 patients in SoC matched and were included into the analysis. Mean ± SD patient age was 67.4 ± 16.7 and 67.1 ± 16.3 years in anakinra and SoC groups, respectively ( p = 0.9). Male gender was 38 (48.7%) in anakinra and 36 (46.2%) in SoC ( p = 0.8). Overall, ICU admission was in 14.1% ( n = 11) and 30.8% ( n = 24) ( p = 0.013; OR 6.2), intubation in 12.8% ( n = 10) and 16.7% ( n = 13) patients ( p = 0.5), and 14.1% ( n = 11) and 32.1% ( n = 25) patients died in anakinra and control groups, respectively ( p = 0.008; OR 7.1). Conclusion In our study, mortality was lower in patients receiving anakinra compared to SoC. Intravenous high-dose anakinra is safe and effective treatment in patients with severe and critical COVID-19. Supplementary Information The online version contains supplementary material available at 10.1007/s10787-023-01138-8.

Objective: Many observational studies have reported high morbidity and mortality associated with COVID-19 during hospitalisation. This study aimed to examine the longterm symptoms and related factors of patients hospitalised due to COVID-19. Materials and Methods:Clinical and laboratory characteristics of 266 patients who were followed up in the hospital with the diagnosis of COVID-19 were recorded. The patients were followed for an average of 14 weeks after discharge. The discharged patients were surveyed for their symptoms by calling.Results: On average, 14 weeks after being discharged, it was found that a least one symptom persisted in 27.4% (n =73) of 266 patients. The three most common symptoms after discharge were 38.3% (n = 28) cough, headache (36.9%, n = 27), shortness of breath (27.3%, n = 20), respectively. In multivariate analysis, it was found that symptoms persist more in patients with high CRP (C-reactive protein) and ferritin during hospitalisation (p: 0.03; p: 0.005, respectively). Conclusion:After COVID-19, it was observed that complaints continued after discharge in a significant number of patients. During hospitalisation, high ferritin and CRP levels were found to be associated with the persistence of symptoms. It was considered that symptoms associated with COVID-19 persist more in those with a high inflammatory response.

A single center survey study of systemic vasculitis and COVID-19 during the first months of pandemic INTRODUCTION: COVID-19 pandemic created concerns among patients receiving immunosuppressive therapy. Frequency of COVID-19 and impact of lockdown on treatment compliance in patients with vasculitis are largely unknown.PATIENTS AND METHOD: Patients with ANCA-associated and large vessel vasculitis that have been followed-up in our clinic were contacted by phone and a questionnaire containing home isolation status, treatment adherence and history of COVID-19 between March 1st and June 30th, 2020 was applied. RESULTS: The survey was applied to 103 patients (F/M: 59/44, mean age: 53.2±12.5). Thirtythree (32%) patients didn't attend at least one appointment; 98(95.1%) noted that they spent 3 months in home isolation. Five patients (4.8%) received immunosuppressives irregularly and 3(2.9%) developed symptoms due to undertreatment. Four (3.9%) patients admitted to hospital with a suspicion of COVID-19, but none of them had positive PCR or suggestive findings by imaging. COVID-19 diagnosed in a patient with granulomatosis with polyangiitis during hospitalization for disease flare and she died despite treatment. DISCUSSION: Frequency of COVID-19 was low in patients with vasculitis in our single center cohort during the first months of pandemic. Although outpatient appointments were postponed in one-third of our patients, high compliance with treatment and isolation rules ensured patients with vasculitis overcome this period with minimal morbidity and mortality.