Department of Clinical Pharmacy Services, Bumrungrad International Hospital, Bangkok, Thailand.
Department of Medicine, Bumrungrad International Hospital, Bangkok, Thailand.
BMJ Case Rep. 2022 May 10;15(5):e248520. doi: 10.1136/bcr-2021-248520.
Multisystem inflammatory syndrome in adults (MIS-A) has been reported as a rare but severe consequence of COVID-19 infection. Adult patients were more likely to present with hypotension and cardiac illness when compared with multisystem inflammatory syndrome in children. Although the exact prevalence of MIS-A is unknown, more cases have been observed in men and younger adults. The pathophysiology of MIS-A is also unclear, but is thought to be caused by a delayed, dysregulated immune response. Given no established guideline for treatment of MIS-A, treatment has been based on case reports. We present a case of MIS-A in a woman in her 60s who had severe hypotension, progressive dyspnoea, massive pleural effusion, hypoxaemia, thyroiditis and multiple organ failure, which dramatically improved after treatment with corticosteroid and interleukin 6 inhibitor.
成人多系统炎症综合征（MIS-A）已被报道为 COVID-19 感染的一种罕见但严重的后果。与儿童多系统炎症综合征相比，成年患者更有可能出现低血压和心脏疾病。尽管 MIS-A 的确切患病率尚不清楚，但在男性和年轻成年人中观察到更多的病例。MIS-A 的病理生理学也不清楚，但据认为是由延迟、失调的免疫反应引起的。由于没有针对 MIS-A 的既定治疗指南，因此治疗是基于病例报告的。我们报告了一例 60 多岁女性的 MIS-A 病例，她患有严重的低血压、进行性呼吸困难、大量胸腔积液、低氧血症、甲状腺炎和多器官衰竭，在接受皮质类固醇和白细胞介素 6 抑制剂治疗后病情显著改善。
