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成人新冠后多系统炎症综合征(MIS-A)伴横纹肌溶解和急性肾损伤

Post-COVID Multisystem Inflammatory Syndrome-Adult (MIS-A) Presenting with Rhabdomyolysis and AKI.

作者信息

Mazumder Mastakim Ahmed, Narula Ajit Singh, Gulati Sanjeev, Shehwar Durre, Mir Ishrat Majid

机构信息

Consultant Nephrology and Kidney Transplant, Kidney and Urology Institute, Fortis Escorts, Okhla, New Delhi, India.

Director Nephrology and Kidney Transplant, Kidney and Urology Institute, Fortis Escorts, Okhla, New Delhi, India.

出版信息

Indian J Nephrol. 2022 Nov-Dec;32(6):629-632. doi: 10.4103/ijn.ijn_284_21. Epub 2022 Dec 1.

Abstract

Multisystem inflammatory syndrome is a rarely reported post-COVID (coronavirus disease) phenomenon in adults. Our understanding of the multisystem inflammatory syndrome- adult (MIS-A) is based on multiple case reports that have demonstrated heterogeneous clinical presentations and treatment options. Rhabdomyolysis is an unusual presentation of MIS-A. We report the case of a 61-year-old man who presented with rhabdomyolysis with acute kidney injury (AKI), acute inflammatory demyelinating polyneuropathy (AIDP), myocarditis, disseminated intravascular coagulation, and minimal respiratory symptoms. The patient was found to have post-COVID inflammatory syndrome and recovered with supportive treatment and intravenous immunoglobulin (2 g/kg over 5 days). COVID-19 (coronavirus disease 2019) antibody positivity played a significant role in making the diagnosis of MIS-A and in providing prompt treatment.

摘要

多系统炎症综合征是一种在成人中鲜有报道的新冠(冠状病毒病)后现象。我们对成人多系统炎症综合征(MIS-A)的认识基于多例病例报告,这些报告显示了其临床表现和治疗方案的异质性。横纹肌溶解是MIS-A的一种不寻常表现。我们报告了一名61岁男性的病例,该患者出现横纹肌溶解并伴有急性肾损伤(AKI)、急性炎症性脱髓鞘性多发性神经病(AIDP)、心肌炎、弥散性血管内凝血,且呼吸道症状轻微。该患者被诊断为新冠后炎症综合征,经支持治疗和静脉注射免疫球蛋白(5天内2 g/kg)后康复。新型冠状病毒肺炎(2019冠状病毒病)抗体阳性在MIS-A的诊断和及时治疗中发挥了重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66b0/9872915/51fe260a779c/IJN-32-629-g001.jpg

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