Miscellaneous

Cairo University Hospital: VEXAS Syndrome Patient Contracted COVID-19 in 2021

By Sama Marwan,

Dr. Hossam Salah, Dean of the Faculty of Medicine and Chairman of the Hospitals Board, held an unprecedented meeting with the medical team that diagnosed a case of VEXAS syndrome. The meeting discussed all details of the case and the treatment approach that has been developed so far, along with the future treatment plan.

Recognition and Appreciation for Efforts

At the start of the meeting, Dr. Hossam Salah expressed his gratitude to the medical team, emphasizing his pride in their efforts in diagnosing and treating the condition.

Dr. Yousry Aql, Professor and Chair of the Department of Pulmonary Diseases and the leader of the team that discovered the VEXAS syndrome case, provided a detailed presentation on the development of the case since symptoms appeared in the 72-year-old patient.

He clarified that the patient had contracted COVID-19 in 2021 and was treated at home. However, over time, additional symptoms appeared, including recurring fevers, anemia, thrombocytopenia, skin rashes, and hearing loss. Based on these symptoms, a multidisciplinary team was formed to conduct the necessary tests and determine the correct diagnosis.

Analysis and Diagnosis of VEXAS Syndrome

Dr. Hala Frawela, Professor of Clinical Pathology, discussed the significance of the bone marrow sample analysis, which played a key role in confirming the VEXAS diagnosis. She explained that the presence of “distinct vacuoles” in the cells was a major indicator that helped confirm the diagnosis after excluding similar diseases.

Dr. Hala El-Gendy, Professor of Internal Medicine and Immunology, spoke about the factors that supported the diagnosis of VEXAS syndrome. She noted that multiple symptoms such as skin rashes, pneumonia, and blood disorders were clear indicators of the syndrome. She added that she had studied a similar rare case sent to her by an international journal for review, and the final diagnosis confirmed that the case the team treated was indeed a rare VEXAS syndrome case.

Medical Team’s Role in Diagnosing Rare Dermatological Symptoms

Dr. Mona Rabea El-Sayed Abdel Halim, Professor of Dermatology and Skin Pathology, along with Dr. Marwa Amer, Assistant Professor of Dermatology and member of the International Psoriasis Council, presented the dermatological findings. They explained that the patient had suffered from three different types of skin rashes in various parts of his body. Additionally, abnormal proliferation of histiocytes and rare tissue changes similar to Kikuchi’s disease were found. This is the second case globally where such dermatological symptoms appeared in a VEXAS patient.

Treatment Plan and Future Outlook

In conclusion, Dr. Nehal Ghabashi, Assistant Professor of Rheumatology and Immunology and the attending physician, reviewed the patient’s treatment plan. She confirmed that the patient’s condition is currently stable and that steroid doses are being gradually reduced to minimize side effects. Immunosuppressive medications continue to be used to control disease activity, and the patient is showing continuous improvement, with symptoms gradually subsiding.

Ongoing Research and Scientific Commitment

Dr. Hossam Salah expressed his great appreciation for the team’s efforts in diagnosing and treating this rare case. He also emphasized his commitment to ensuring that all necessary resources are provided for the development of treatments for complex cases. He highlighted the importance of cooperation among experts from various specialties to achieve the best outcomes and urged continuous scientific research and specialized medical reviews to ensure sustainable progress in treating complex diseases like VEXAS syndrome.

In his closing remarks, Dr. Salah recommended intensifying future research on VEXAS syndrome to expand understanding of its pathogenic mechanisms, and suggested the creation of specialized research and treatment centers in this field. This would contribute to enhancing Cairo University’s Faculty of Medicine’s reputation as a leading center for the treatment of complex and rare diseases.

Participating Medical Team:

  • Prof. Dr. Yousry Aql – Professor of Pulmonary Diseases
  • Prof. Dr. Hala Frawela – Professor of Pathology
  • Prof. Dr. Hala El-Gendy – Professor of Internal Medicine and Immunology
  • Prof. Dr. Mona Rabea – Professor of Dermatology and Skin Pathology
  • Prof. Dr. Mohamed Said – Professor of Pulmonary Diseases
  • Prof. Dr. Marwa Amer – Assistant Professor of Dermatology and member of the International Psoriasis Council
  • Prof. Dr. Nehal Ghabashi – Assistant Professor of Rheumatology and Immunology
  • Prof. Dr. Ibrahim Qanswa – Assistant Professor of Hematology
  • Prof. Dr. Hamza Said – Assistant Professor of Pulmonary Diseases
  • Dr. Mostafa Saad – Assistant Professor of Internal Medicine
  • Dr. Rania Fared – Assistant Professor of Internal Medicine

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