Markoulaki Despina, Iordanou Stelios, Koukios Demetris, Christoldoulou Ioanna, Papadopoulos Panos, Timiliotou-Matsentidou Chrystalla
Intensive Care Unit, Limassol General Hospital, Limassol, CYP.
Cureus. 2022 Feb 26;14(2):e22640. doi: 10.7759/cureus.22640. eCollection 2022 Feb.
Multisystem inflammatory syndrome (MIS) in adults associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is increasingly reported in published literature, although published reports remain sparse. In this report, we describe our first experience with a 31-year-old Caucasian male who developed severe MIS 31 days after a mild SARS-CoV-2 infection. The patient developed fever, elevated C-reactive protein (CRP), procalcitonin (PCT), reduced ejection fraction (EF), and shock. After extensive diagnostic work-up, nothing was found to justify his shock manifestation. A similar treatment to MIS in children (MIS-C) with immunoglobulins, corticosteroids, and anticoagulants led to a remarkable clinical improvement. MIS in adults (MIS-A) can be fatal. The early identification of MIS plays a crucial role in the prompt initiation of suitable treatment. Therefore, differential diagnosis and exclusion of other causes of illness are of priority. We believe that MIS in children treatment guidelines can be reformed in a way to include MIS in adults as well.
尽管已发表的报告仍然很少，但成人多系统炎症综合征（MIS）与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染相关的情况在已发表的文献中越来越多地被报道。在本报告中，我们描述了我们对一名31岁白人男性的首次治疗经验，该患者在轻度SARS-CoV-2感染31天后出现了严重的MIS。患者出现发热、C反应蛋白（CRP）升高、降钙素原（PCT）升高、射血分数（EF）降低和休克。经过广泛的诊断检查，未发现任何可解释其休克表现的原因。采用与儿童多系统炎症综合征（MIS-C）相似的治疗方法，即使用免疫球蛋白、皮质类固醇和抗凝剂，使患者的临床症状得到了显著改善。成人多系统炎症综合征（MIS-A）可能是致命的。早期识别MIS对及时开始适当治疗起着关键作用。因此，优先进行鉴别诊断并排除其他病因。我们认为，可以对儿童MIS治疗指南进行修订，使其也涵盖成人MIS。
