Multisystem Inflammatory Syndrome In An Adult (MIS-A ... - PubMed

Full text links CiteDisplay options Display options Format AbstractPubMedPMID

Abstract

During the current SARS-CoV-2 pandemic, a novel syndrome termed "multisystem inflammatory syndrome in children" (MIS-C) has emerged. MIS-C was linked to COVID-19 and shared some features with Kawasaki disease and Toxic Shock Syndrome, with a common pathogenetic substrate of hyperinflammation and cytokine storm. Lately, MIS was also described in adults (≥21 years of age) and named "MIS-A". There is no consensus about the treatment of MIS-A; successful use of glucocorticoids and immunoglobulins has been reported in case series, but more solid evidence is lacking. Furthermore, the role of biologic agents with proven benefits against COVID-19, MIS-C, or Kawasaki disease is still unexplored. In this report, we detail the clinical picture and the diagnostic process that led to the diagnosis of MIS-A in a 27-year-old man, focusing on its treatment with anakinra and glucocorticoids, which resulted in full recovery. To our knowledge, this is the first report of the successful use of anakinra for MIS-A, a drug that has already proven useful in the treatment of refractive cases of MIS-C. Anakinra may also play a pivotal role for the treatment of MIS-A.

Keywords: COVID-19; MIS-A; SARS-CoV-2; anakinra; multisystem inflammatory syndrome.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1

Annular lesions of the trunk…

Figure 1

Annular lesions of the trunk and neck.

Figure 2

Case timeline.

Figure 2

Case timeline.

See this image and copyright information in PMC

References

1. 1. Vogel T.P., Top K.A., Karatzios C., Hilmers D.C., Tapia L.I., Moceri P., Giovannini-Chami L., Wood N., Chandler R.E., Klein N.P., et al. Multisystem inflammatory syndrome in children and adults (MIS-C/A): Case definition & guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine. 2021;39:3037–3049. doi: 10.1016/j.vaccine.2021.01.054. - DOI - PMC - PubMed
2. 1. Morris S.B., Schwartz N.G., Patel P., Abbo L., Beauchamps L., Balan S., Lee E.H., Paneth-Pollak R., Geevarughese A., Lash M.K., et al. Case Series of Multisystem Inflammatory Syndrome in Adults Associated with SARS-CoV-2 Infection—United Kingdom and United States, March–August 2020. MMWR. Morb. Mortal. Wkly. Rep. 2020;69:1450–1456. doi: 10.15585/mmwr.mm6940e1. - DOI - PMC - PubMed
3. 1. Sokolovsky S., Soni P., Hoffman T., Kahn P., Scheers-Masters J. COVID-19 associated Kawasaki-like multisystem inflammatory disease in an adult. Am. J. Emerg. Med. 2021;39:253.e1–253.e2. doi: 10.1016/j.ajem.2020.06.053. - DOI - PMC - PubMed
4. 1. Shaigany S., Gnirke M., Guttmann A., Chong H., Meehan S., Raabe V., Louie E., Solitar B., Femia A. An adult with Kawasaki-like multisystem inflammatory syndrome associated with COVID-19. Lancet. 2020;396:e8–e10. doi: 10.1016/S0140-6736(20)31526-9. - DOI - PMC - PubMed
5. 1. Kofman A.D., Sizemore E.K., Detelich J.F., Albrecht B., Piantadosi A.L. A young adult with COVID-19 and multisystem inflammatory syndrome in children (MIS-C)-like illness: A case report. BMC Infect. Dis. 2020;20:716. doi: 10.1186/s12879-020-05439-z. - DOI - PMC - PubMed

Show all 17 references

Publication types

• Case Reports Actions
  • Search in PubMed
  • Search in MeSH
  • Add to Search

LinkOut - more resources

• Full Text Sources

  • Europe PubMed Central
  • MDPI
  • PubMed Central

• Miscellaneous

  • NCI CPTAC Assay Portal