A CASE OF PULMONARY EMBOLISM POST COVID-19 INFECTION IN A PATIENT WITH STAT3 MUTATION

Abstract

<h3>Introduction</h3> Signal transducer and activator of transcription 3 (STAT3) is a transcriptional regulator that plays an important role in controlling the innate and adaptive immune system. Hyper IgE syndrome, caused by a STAT3 deficiency, is a rare disorder that commonly presents with connective tissue, skeletal, and vascular abnormalities. Known vasculopathies seen in this syndrome include aneurysms and thrombotic events frequently in coronary and cerebral vascular systems. <h3>Case Description</h3> We report a 55-year-old white male with a known STAT3 deficiency based on clinical symptomology and genetic testing. The patient has been on monthly intravenous immunoglobulin therapy. He has refused active and passive immunization to COVID-19 due to religious reasons. Soon after a COVID-19 infection he presented with dyspnea, leg swelling, and chest pain. Worsening symptoms caused him to be admitted to the hospital and a V/Q scan was performed. The result showed a pulmonary embolism of the left lower lobe, he was treated for this condition and then discharged from the hospital. <h3>Discussion</h3> STAT3 deficient patients typically present with a triad of symptoms: eosinophilia, atopic dermatitis, and pulmonary/skin infections. The complication of recurrent vasculopathies, including clots, has been seen in many patients with a STAT3 deficiency. Outside of STAT3 deficient patients, there has been multiple clinical scenarios where pulmonary embolisms have been present in patients after a COVID-19 infection. This is the first published case of a STAT3 deficient patient presenting with a pulmonary embolism due to a COVID infection.