Post COVID-19 multisystem inflammatory syndrome in adults (MIS-A): Underappreciated in international health? A Case Series

Clinical Immunology Communications Pub Date : 2024-05-01 DOI:10.1016/j.clicom.2024.04.003

Marvyn T. Koning , Anouk Haine , Jesse Fens , Edske ter Bals , M. Cloos-van Balen , A. Faiz Karim

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Abstract

Multisystem Inflammatory Syndrome in Adults (MIS-A) is a rare complication after COVID-19 that mainly occurs in young adults. Patients typically present with unremitting fever, rash, conjunctivitis, neurological signs, shock, gastrointestinal symptoms and thrombocytopenia. Reported cases are scarce. Here we describe three new cases.

It is unclear to what extent MIS-A has a genetic basis, or whether MIS-A patients can be safely vaccinated after a case of MIS was reported after vaccination (termed MIS-V). We describe a monozygotic twin who was vaccinated without complications, suggesting no strict genetic basis for MIS-V. Furthermore, we report only the second case of MIS-A-related coronary aneurysm, which fully resolved upon regular treatment.

With the majority of young adults living in low resources settings, we suggest more focus on clinical parameters to support a MIS-A diagnosis. We report the first two patients of North-African descent. Currently, MIS-A may be an underappreciated complication of COVID-19 due to the lack of reports in non-Caucasian populations.

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COVID-19 后成人多系统炎症综合征（MIS-A）：在国际卫生领域未得到充分重视？病例系列

成人多系统炎症综合征（MIS-A）是 COVID-19 后的一种罕见并发症，主要发生在青壮年身上。患者通常表现为持续发热、皮疹、结膜炎、神经系统症状、休克、胃肠道症状和血小板减少。报道的病例很少。目前还不清楚 MIS-A 在多大程度上有遗传基础，也不清楚在接种疫苗后出现 MIS 病例（称为 MIS-V）后，MIS-A 患者是否可以安全接种疫苗。我们描述了一例接种疫苗后未出现并发症的单卵双生子，这表明 MIS-V 没有严格的遗传基础。此外，我们仅报告了第二例与 MIS-A 相关的冠状动脉瘤病例，该病经正规治疗后完全消退。由于大多数年轻人生活在资源匮乏的环境中，我们建议更多关注临床参数以支持 MIS-A 的诊断。我们首次报告了两名北非裔患者。目前，由于缺乏对非高加索人群的报道，MIS-A 可能是 COVID-19 的一种未被充分重视的并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Clinical Immunology Communications

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