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一名年轻成年人的新型冠状病毒肺炎相关多系统炎症综合征

COVID-19-related Multisystem Inflammatory Syndrome in a Young Adult.

作者信息

Pombo Francisco, Seabra Carolina, Soares Vergilio, Sá Ana João, Ferreira Inês, Mendes Marina

机构信息

Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal.

出版信息

Eur J Case Rep Intern Med. 2021 Apr 19;8(4):002520. doi: 10.12890/2021_002520. eCollection 2021.

Abstract

INTRODUCTION

A condition called multisystem inflammatory syndrome in children (MIS-C), related to past SARS-CoV-2 infection, has been described in a series of cases. There is a growing body of evidence suggesting a similar entity in adults (MIS-A). We report a case of a young adult with a hyperinflammatory systemic syndrome with end-organ lesions and a recent SARS-CoV-2 infection.

METHODS AND PROCEDURES

The patient developed end-organ lesions in the respiratory, cardiovascular, digestive, haematological and mucocutaneous systems. A wide diagnostic work-up did not find any specific aetiology (autoimmunity, neoplastic or infectious). There was evidence of past SARS-CoV-2 infection with positive autoimmune titres (positive IgG). A presumptive diagnosis of MIS-A was made and treatment with corticosteroids was introduced with improvement.

DISCUSSION

COVID-19-related multisystem inflammatory syndrome in adults is still an unknown entity with no diagnostic criteria or treatment guidelines. Much of what is known is inferred from what we already know about MIS-C. There have been several reported cases with severity ranging from mild to severe. The mechanisms behind this condition are still largely unknown. More evidence is needed to establish diagnosis and treatment.

LEARNING POINTS

COVID-19-related multisystem inflammatory syndrome in adults is a new entity with few case reports.Awareness is important for early diagnosis and treatment.

摘要

引言

在一系列病例中描述了一种名为儿童多系统炎症综合征(MIS-C)的病症,它与既往的严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染有关。越来越多的证据表明成人中存在类似病症(MIS-A)。我们报告了一例年轻成人病例,其患有伴有终末器官病变的高炎症性全身综合征且近期感染了SARS-CoV-2。

方法与步骤

该患者在呼吸、心血管、消化、血液及皮肤黏膜系统出现了终末器官病变。广泛的诊断性检查未发现任何特定病因(自身免疫、肿瘤或感染)。有既往SARS-CoV-2感染的证据且自身抗体滴度呈阳性(IgG阳性)。做出了MIS-A的推测性诊断,并引入皮质类固醇治疗,患者病情有所改善。

讨论

成人中与冠状病毒病2019(COVID-19)相关的多系统炎症综合征仍是一个未知实体,尚无诊断标准或治疗指南。目前已知的大部分内容是从我们对MIS-C的了解中推断出来的。已有几例报告病例,严重程度从轻度到重度不等。这种病症背后的机制在很大程度上仍然未知。需要更多证据来确立诊断和治疗方法。

学习要点

成人中与COVID-19相关的多系统炎症综合征是一个新实体,病例报告较少。提高认识对于早期诊断和治疗很重要。

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