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成人接种新冠疫苗后出现多系统炎症综合征:病例报告和文献复习。

Multisystem Inflammatory Syndrome in an Adult after COVID-19 Vaccination: a Case Report and Literature Review.

机构信息

Department of Internal Medicine, Division of Infectious Disease, Soonchunhyang University Hospital, Cheonan, Korea.

Department of Internal Medicine, Division of Rheumatology, Soonchunhyang University Hospital, Cheonan, Korea.

出版信息

J Korean Med Sci. 2021 Nov 22;36(45):e312. doi: 10.3346/jkms.2021.36.e312.

Abstract

As the number of people vaccinated increases, people who complain of adverse reactions continue to occur. We experienced a case characterized by low blood pressure, persistent fever, edema due to increased systemic vascular permeability, and systemic inflammation confirmed by image and laboratory examinations after ChAdOx1 coronavirus disease 2019 (COVID-19) vaccination. The diagnostic criteria for multisystem inflammatory syndrome (MIS) in adults are known as fever of 3 days or more in adults, 2 or more mucocutaneous/gastrointestinal/neurologic symptoms, elevation of inflammatory markers, and clinical/imaging diagnosis of heart failure. A 67-year-old man who was medicated for hypertension and diabetes was admitted complaining of fever, maculopapular rash, diarrhea, headache, chills, and dizziness 6 days after the first vaccination of ChAdOx1 nCoV-19 in Korea. The COVID-19 test was negative but with low blood pressure, leukocytosis, skin rash, pulmonary edema, and increased inflammation markers. His lab findings and clinical course were consistent with those of MIS after COVID-19 vaccination. He was medicated with methylprednisolone 1 mg/kg and diuretics and recovered rapidly. He was discharged after 2 weeks and confirmed cure at outpatient clinic. We report an MIS case after COVID-19 vaccination in Korea.

摘要

随着接种人数的增加,继续出现不良反应的人。我们遇到了一例以低血压、持续发热、全身血管通透性增加引起的水肿和全身炎症为特征的病例,这些都是通过 ChAdOx1 冠状病毒病 2019(COVID-19)疫苗接种后的影像和实验室检查证实的。成人多系统炎症综合征(MIS)的诊断标准为成人发热 3 天或以上、2 个或更多黏膜皮肤/胃肠道/神经系统症状、炎症标志物升高以及心力衰竭的临床/影像学诊断。一名 67 岁男性患有高血压和糖尿病,在韩国接种 ChAdOx1 nCoV-19 第一针后 6 天因发热、斑丘疹、腹泻、头痛、寒战和头晕而住院。COVID-19 检测呈阴性,但血压低、白细胞增多、皮疹、肺水肿和炎症标志物增加。他的实验室检查结果和临床过程与 COVID-19 疫苗接种后的 MIS 一致。他接受了 1 毫克/千克甲基强的松龙和利尿剂治疗,迅速康复。他在两周后出院,并在门诊确认治愈。我们报告了韩国 COVID-19 疫苗接种后 MIS 病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ab1/8608920/0f9aad5891d2/jkms-36-e312-g001.jpg

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