Browsing by Author "Franzetti, Marco"

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    Interleukin-1 receptor antagonist anakinra in association with remdesivir in severe COVID-19: A case report.
    (International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2020-08) Franzetti, Marco; Pozzetti, Ugo; Carugati, Manuela; Pandolfo, Alessandro; Molteni, Chiara; Faccioli, Paolo; Castaldo, Gioacchino; Longoni, Ernesto; Ormas, Valentina; Iemoli, Enrico; Piconi, Stefania
    We report the first successful treatment with the IL-1 receptor antagonist anakinra, in association with the most promising and available antiviral therapy, of a severe case of novel coronavirus disease 2019 (COVID-19). We describe the diagnosis, clinical course, and management of the case, including the respiratory failure at presentation, the progression to a scenario characterized by profound inflammatory dysregulation similar to that observed during macrophage activation syndrome, and the clinical improvement after treatment with the IL-1 receptor antagonist anakinra. This case highlights the high tolerability and the interesting immunomodulatory profile of the IL-1 receptor antagonist anakinra in the setting of severe COVID-19 associated with remdesivir therapy. Further studies are needed to confirm the safety and efficacy of this combination strategy in the treatment of this emerging infection.
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    Systemic lupus erythematosus and HIV infection: a whimsical relationship. Reports of two cases and review of the literature.
    (Clinical rheumatology, 2013-09) Carugati, Manuela; Franzetti, Marco; Torre, Alessandro; Giorgi, Riccardo; Genderini, Augusto; Strambio de Castilla, Francesco; Gervasoni, Cristina; Riva, Agostino

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    Systemic lupus erythematosus (SLE) is rarely reported in association with HIV infection. We describe two unpredictable cases and provide a review of the literature. Retrospective analysis of the medical records of two HIV-infected patients diagnosed with SLE and admitted at Luigi Sacco Hospital (Milano, Italy). Search of the literature from 1981 to 2012 and review of the cases reported. Case 1: a 32-year-old HIV-infected African woman who developed a SLE flare after re-introduction of antiretroviral therapy (ART). The flare was characterized by bullous skin eruption and membranous glomerulonephritis. Case 2: a 44-year-old Caucasian woman, admitted to our hospital because of lacunar stroke: HIV infection and SLE were simultaneously diagnosed.

    Literature

    55 cases of SLE in the setting of HIV infection were reported. Forty-five patients met the requirements of the American College of Rheumatology for the diagnosis of SLE. The diagnosis of SLE preceded HIV infection in six patients. On the contrary, in 29 patients, HIV infection was reported before SLE. Median CD4+ count at SLE diagnosis was 361 cells/μl. A SLE manifestation following ART immune recovery was documented in 18.2% of the cases. On the contrary, the progression of HIV infection paralleled with SLE remission in 22.5% of the patients. The study shows that an autoimmune disease such as SLE can occur despite the loss of immunocompetence caused by HIV infection. Moreover, SLE and HIV infection influence each other possibly through immunologic mechanisms determining awkward manifestations.