Multisystem inflammatory syndrome in an adult with severe hypoxaemia and thyroiditis responsive to corticosteroid and interleukin 6 inhibitor treatment

BMJ Case Rep. 2022 May 10;15(5):e248520. doi: 10.1136/bcr-2021-248520.

Abstract

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.

Keywords: COVID-19; Intensive care.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • COVID-19 Drug Treatment*
  • COVID-19* / complications
  • Child
  • Female
  • Humans
  • Hypotension*
  • Hypoxia / drug therapy
  • Hypoxia / etiology
  • Interleukin-6
  • Male
  • SARS-CoV-2
  • Systemic Inflammatory Response Syndrome / drug therapy
  • Thyroiditis*

Substances

  • Adrenal Cortex Hormones
  • Interleukin-6

Supplementary concepts

  • adult multisystem inflammatory disease, COVID-19 related
  • pediatric multisystem inflammatory disease, COVID-19 related