Multisystem Inflammatory Syndrome With Complete Kawasaki Disease Features Associated With SARS-CoV-2 Infection in a Young Adult. A Case Report
Multisystem Inflammatory Syndrome With Complete Kawasaki Disease Features Associated With SARS-CoV-2 Infection in a Young Adult. A Case Report
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DOI：
10.3389/fmed.2020.00428
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发表时间：
2020-07-14
影响因子：
3.9
通讯作者：
De Backer, Daniel
中科院分区：
文献类型：
--
作者：
Cogan, Elie;Foulon, Pierre;De Backer, Daniel
最近报告了一种与川崎病表现相关的严重多系统炎症综合征(MIS-C)，这些儿童最近有感染SARS-CoV-2的迹象。我们在此报告一位年轻的成年女性，她在短暂性嗅觉障碍后数周出现川崎病的完整表现，并伴有严重心肌炎、急性呼吸窘迫综合征和血流动力学不稳定。在没有检测到病毒的情况下检测到针对SARS-CoV-2的特定抗体表明，该综合征是对最近的新冠肺炎感染的延迟免疫反应的结果。秋水仙碱、托西珠单抗、大剂量免疫球蛋白和甲基强的松龙的联合治疗可以控制炎症过程并限制冠状动脉动脉瘤的发展。病人痊愈了，没有后遗症。该病例强调了SARS-CoV-2血清学在新冠肺炎迟发性免疫并发症诊断中的重要性。护理成人患者的临床医生必须意识到，不仅儿童，年轻人也可能受到与新冠肺炎相关的具有KD特征的多系统炎症综合征的影响。
A severe multisystem inflammatory syndrome associated with Kawasaki disease manifestations (MIS-C) has been recently reported in children with signs of recent infection with SARS-CoV-2. We here reported the case of a young adult woman who presented the complete manifestations of Kawasaki disease associated with a severe myocarditis, acute respiratory distress syndrome and hemodynamic instability a few weeks after a transient anosmia. The detection of specific antibodies to SARS-CoV-2 in the absence of detection of the virus suggested that the syndrome was the result of a delayed immune response to a recent COVID-19 infection. A combined treatment with colchicine, tocilizumab, high dose immunoglobulins, and methylprednisolone allowed to control the inflammatory process and to limit the development of coronary aneurysm. The patient recovered without sequelae. This case emphasized the importance of SARS-CoV-2 serology for the diagnosis of delayed immune complications of COVID-19. Clinicians caring for adult patients must be aware that not only children but also young adults can be affected by a multisystem inflammatory syndrome with KD features associated with COVID-19.