A Case of Multisystem Inflammatory Syndrome in an Immunosuppressed Adult

Abstract

Multisystem inflammatory syndrome in an adult (MIS-A) is a rare immunological complication that gained prominence after the coronavirus disease 2019 pandemic. Patients with MIS-A often clinically present with non-specific generalized symptoms, such as fever, myalgia, or fatigue, making the diagnosis difficult. In this article, we present an unusual case of MIS-A in a 50-year-old male that raises the question of whether the immune system’s dysregulation will demonstrate differing criteria of signs and symptoms for a patient on sustained immunosuppression as opposed to the non-immunosuppressed population.

Multisystem inflammatory syndrome in adults: Characteristics, treatment, and outcomes

“…The favorable outcomes including rapid recovery after early use of corticosteroids with or without IVIG have been reported in several MIS-A cases and suggested the promising role of these two anti-inflammatory agents for patients with MIS-A. 31,33,64,71,72 However, further study is warranted to investigate the efficacy and safety of corticosteroids and IVIG in the treatment of MIS-A. Other anti-inflammatory medications, such as tocilizumab, an IL-6 receptor inhibitor, and anakinra, an IL-1 receptor antagonist, were used in 42 (21%) of 203 cases.…”

“…In a systematic review by Patel et al, 16 corticosteroids and IVIG were administered to 152 (74%) and 112 (55%) of 205 patients with MIS‐A, respectively. The favorable outcomes including rapid recovery after early use of corticosteroids with or without IVIG have been reported in several MIS‐A cases and suggested the promising role of these two anti‐inflammatory agents for patients with MIS‐A 31,33,64,71,72 . However, further study is warranted to investigate the efficacy and safety of corticosteroids and IVIG in the treatment of MIS‐A.…”