病例报告：成人新冠后多系统炎症综合征和血栓性微血管病。
Case Report: Adult Post-COVID-19 Multisystem Inflammatory Syndrome and Thrombotic Microangiopathy.
机构信息
Groupe Hospitalier Sud Ile de France, Service de Réanimation, Melun, France.
Centre Hospitalo-Universitaire Necker, Service d'Anatomie Pathologique, Paris, France.
出版信息
Front Immunol. 2021 Jun 23;12:680567. doi: 10.3389/fimmu.2021.680567. eCollection 2021.
BACKGROUND
The coronavirus disease 2019 (COVID-19) pandemic has affected millions of people worldwide. A clinical series of Kawasaki-like multisystem inflammatory syndrome (MIS), occurring after SARS-CoV-2 infection, have been described in children (MIS-C) and adults (MIS-A), but the pathophysiology remains unknown.
CASE PRESENTATION
We describe a case of post-COVID-19 MIS-A in a 46-year-old man with biopsy-proven renal thrombotic microangiopathy (TMA). Specific complement inhibition with eculizumab was initiated promptly and led to a dramatic improvement of renal function.
CONCLUSION
Our case suggests that that TMA could play a central role in the pathophysiology of post-COVID-19 MIS-A, making complement blockers an interesting therapeutic option.
背景
2019 年冠状病毒病（COVID-19）大流行已影响到全球数百万人。在 SARS-CoV-2 感染后，已在儿童（MIS-C）和成人（MIS-A）中描述了一系列类似于川崎病的全身性炎症综合征（MIS），但其病理生理学仍不清楚。
病例介绍
我们描述了一例 COVID-19 后 MIS-A 病例，患者为 46 岁男性，肾活检证实为血栓性微血管病（TMA）。迅速开始使用依库珠单抗进行特异性补体抑制治疗，导致肾功能显著改善。
结论
我们的病例提示 TMA 可能在 COVID-19 后 MIS-A 的病理生理学中起核心作用，使补体抑制剂成为一种有趣的治疗选择。
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