Case of multisystem inflammatory syndrome in adults

Abstract

Introduction and aim. Multisystem inflammatory syndrome in adults (MIS-A) is a rare severe illness which is related to prior SARS-CoV2 infection in individuals>=21 years old. The condition was described few months after recognition of similar entity in children known as MIS-C (United Kingdom, April, 2020). The diagnosis of MIS-A is based on clinical symptoms andevidence of inflammation in laboratory markers. It is characterized by extrapulmonary organ dysfunction (cardiovascular, gastrointestinal), general symptoms such as fever, malaise, rash and deviations in blood tests (elevated level of ferritin, procalcitonin, CRP, IL-6, D-Dimer) with a previous or current SARS-CoV-2 infection. The purpose of this study is to present the syndrome on the basis of a clinical case example, to show the course of the disease, its symptoms and the result of applied treatment. Description of the case. The following case describes the clinical history, diagnostic process and applied treatment of 37-year old female patient who was admitted urgently to the hospital with a suspicion of sepsis originating from pharynx. The final diagnosis – MIS-A was settled after performing a broad panel of tests. Clinical picture was non- characteristic. The patient was successfully treated with steroids. Conclusion. MIS-A is a rare clinical entity linked with SARS-CoV-2 infection. The symptoms manifest from multiple organ systems and the diagnostic process may be challenging. The illness can be successfully treated with steroids.