COVID-19 Related Myositis in a Patient Recently Diagnosed with Pre B Cell Acute Lymphoblastic Leukemia

Myositis is not a common finding in patients diagnosed with COVID-19. Up to now, a few cases of COVID-19 associated with myositis have been reported.A 26-year-old man was referred to the hematology clinic due to leukocytosis and bicytopenia in his lab tests. The patient had no symptoms at the visit session. Following the evaluation, he was hospitalized with the diagnosis of pre-B cell Acute Lymphoblastic Leukemia (ALL) and was considered a chemotherapy regimen consisting of vincristine, methotrexate, cytarabine, and prednisolone. Prior to initiating the treatment, he was diagnosed with COVID-19 with manifestations of fever and dyspnea on the 20th day of hospitalization. The positive Polymerase Chain Reaction (PCR) test confirmed the diagnosis. On the 8th day of COVID-19 related clinical and paraclinical manifestations, the patient was complaining about a vague severe pain in the pelvic region predominantly around his hips. A pelvic MRI was performed to rule out critical etiologies and perimuscular and intramuscular edema was revealed. Creatine Phosphokinase (CPK) and Lactate Dehydrogenase (LDH) were elevated in the lab tests. His pain was diminished in few days spontaneously and diagnosis of myositis was confirmed. Myositis can be one of the extra-pulmonary manifestations of COVID-19. Therefore, finding out the association between myositis and COVID-19 can be beneficial for the early diagnosis and prevention of misleading.