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.
Case Description
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.
Discussion
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.
