PDF(Pubmed)
Abstract：
Multisystem Inflammatory Syndrome (MIS) is a novel hyperinflammatory syndrome associated with SARS-CoV-2 infection. It predominantly affects children (MIS-C) a few weeks after a usually asymptomatic SARS-CoV-2 infection and is only rarely seen in adults above 21 years (MIS-A). Only scarce data on histological findings in both pediatric and adult patients has been published so far. An 18-year-old male patient was admitted to hospital in a febrile state, which progressed to severe cardiogenic shock and multi-organ failure requiring extracorporeal life support. Myocardial biopsy revealed small vessel-associated immune cell infiltrates. Diagnosis of MIS-C was made after ruling out all potential differential diagnosis. Use of immunosuppressive treatment with steroids, interleukin-1 blockade and high-dose intravenous immunoglobulins resulted in the patient\'s full recovery. Multisystem Inflammatory Syndrome (MIS) is a new differential diagnosis of cardiac dysfunction in pediatric and adult patients. The lack of myocardial necrosis differentiates the disease from other viral myocarditis and offers an explanation for the fast response to immunomodulatory therapy and the favorable prognosis. The preceding SARS-CoV-2 infection might only have been mildly symptomatic or even asymptomatic.
摘要：
多系统炎症综合征（MIS）是与SARS-CoV-2感染相关的新型高炎性综合征。通常无症状的SARS-CoV-2感染后几周，它主要影响儿童（MIS-C），仅在21岁以上的成年人（MIS-A）中很少见。到目前为止，仅发表了有关小儿和成人患者组织学发现的稀缺数据。一名18岁的男性患者在发热状态下入院，进展为严重的心源性休克和多器官衰竭，需要体外生命支持。心肌活检显示小血管相关免疫细胞浸润。排除所有潜在的鉴别诊断后，对MIS-C进行诊断。使用类固醇的免疫抑制治疗，白细胞介素-1阻滞和大剂量静脉注射免疫球蛋白导致患者完全康复。多系统炎症综合征（MIS）是儿童和成人患者心功能不全的新鉴别诊断。缺乏心肌坏死使该疾病与其他病毒性心肌炎区分开来，并为对免疫调节治疗的快速反应和良好预后提供了解释。先前的SARS-CoV-2感染可能只是轻度症状甚至无症状。
