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一名感染新冠病毒的成年人的多系统炎症综合征——阿那白滞素试验:一例病例报告

Multisystem Inflammatory Syndrome in an Adult With COVID-19-A Trial of Anakinra: A Case Report.

作者信息

Aggarwal Abhimanyu, Cohen Ezra, Figueira Marisol, Sabharwal Vishakha, Herlihy Julie M, Bronwen Carroll, Barnett Elizabeth D, Pelton Stephen I, Camelo Ingrid Y

机构信息

Department of Infectious Diseases, University of Massachusetts School of Medicine-Baystate Medical Center, Springfield, MA.

Department of Pediatrics, Division of Hospital Medicine.

出版信息

Infect Dis Clin Pract (Baltim Md). 2021 Nov;29(6):e420-e423. doi: 10.1097/IPC.0000000000001028. Epub 2021 May 15.

Abstract

COVID-19 disease has been a pandemic caused by a β-coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A life-threatening multisystem inflammatory syndrome (MIS), secondary to SARS-CoV-2 virus infection, sharing common features with Kawasaki disease shock syndrome, staphylococcal/streptococcal shock syndrome, and macrophage activation syndrome in pediatric patients has been described. A total of 27 cases in adults (MIS-A) with a similar presentation have been reported so far. Here we describe the case of a 21-year-old man admitted with abdominal pain, diarrhea, tachycardia, and low blood pressure. He had elevated troponin, ferritin, and interleukin-2 receptor levels and had evidence of myocarditis. He tested positive for SARS-CoV-2 IgG antibody, and a diagnosis of MIS-A was made. Our case adds to the scant literature on this topic, and to our knowledge, it is the first case where anakinra was administered. He recovered well. MIS-A should be considered when young adults present with multiorgan dysfunction.

摘要

新型冠状病毒肺炎(COVID-19)是由一种β冠状病毒——严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的大流行病。已经有文献描述了一种继发于SARS-CoV-2病毒感染的危及生命的多系统炎症综合征(MIS),在儿科患者中,它与川崎病休克综合征、葡萄球菌/链球菌休克综合征以及巨噬细胞活化综合征具有共同特征。迄今为止,共报告了27例具有相似表现的成人病例(成人多系统炎症综合征,MIS-A)。在此,我们描述了一名21岁男性患者的病例,该患者因腹痛、腹泻、心动过速和低血压入院。他的肌钙蛋白、铁蛋白和白细胞介素-2受体水平升高,并有心肌炎的证据。他的SARS-CoV-2 IgG抗体检测呈阳性,被诊断为MIS-A。我们的病例补充了关于该主题的稀少文献,据我们所知,这是首例使用阿那白滞素进行治疗的病例。他恢复良好。当年轻成人出现多器官功能障碍时,应考虑MIS-A。

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