Cogan Elie, Foulon Pierre, Cappeliez Olivier, Dolle Nicole, Vanfraechem Gaëlle, De Backer Daniel
Department of Internal Medicine, CHIREC Hospital, Brussels, Belgium.
Université Libre de Bruxelles (ULB), Brussels, Belgium.
Front Med (Lausanne). 2020 Jul 14;7:428. doi: 10.3389/fmed.2020.00428. eCollection 2020.
A severe multisystem inflammatory syndrome associated with Kawasaki disease manifestations (MIS-C) has been recently reported in children with signs of recent infection with SARS-CoV-2. We here reported the case of a young adult woman who presented the complete manifestations of Kawasaki disease associated with a severe myocarditis, acute respiratory distress syndrome and hemodynamic instability a few weeks after a transient anosmia. The detection of specific antibodies to SARS-CoV-2 in the absence of detection of the virus suggested that the syndrome was the result of a delayed immune response to a recent COVID-19 infection. A combined treatment with colchicine, tocilizumab, high dose immunoglobulins, and methylprednisolone allowed to control the inflammatory process and to limit the development of coronary aneurysm. The patient recovered without sequelae. This case emphasized the importance of SARS-CoV-2 serology for the diagnosis of delayed immune complications of COVID-19. Clinicians caring for adult patients must be aware that not only children but also young adults can be affected by a multisystem inflammatory syndrome with KD features associated with COVID-19.
最近在有新型冠状病毒严重急性呼吸综合征（SARS-CoV-2）近期感染迹象的儿童中报告了一种与川崎病表现相关的严重多系统炎症综合征（MIS-C）。我们在此报告了一名年轻成年女性的病例，该患者在短暂嗅觉减退几周后出现了川崎病的完整表现，并伴有严重心肌炎、急性呼吸窘迫综合征和血流动力学不稳定。在未检测到病毒的情况下检测到SARS-CoV-2特异性抗体，提示该综合征是对近期新型冠状病毒肺炎（COVID-19）感染的延迟免疫反应的结果。秋水仙碱、托珠单抗、高剂量免疫球蛋白和甲泼尼龙联合治疗能够控制炎症过程并限制冠状动脉瘤的发展。患者康复且无后遗症。该病例强调了SARS-CoV-2血清学对诊断COVID-19延迟免疫并发症的重要性。照顾成年患者的临床医生必须意识到，不仅儿童，年轻成年人也可能受到与COVID-19相关的具有川崎病特征的多系统炎症综合征的影响。
