J Korean Med Sci.  2021 Jun;36(25):e181. 10.3346/jkms.2021.36.e181.

The First Case of Multisystem Inflammatory Syndrome in Adult after COVID-19 in Korea

• Chung H
• Seo H
• Park S
• Kim H
• Jung J
• Chong YP
• Kim SH
• Lee SO
• Choi SH
• Kim YS
• Kim MJ

• KMID: 2516990
• DOI: http://doi.org/10.3346/jkms.2021.36.e181

Abstract

Multisystem inflammatory disease in children is a Kawasaki disease like illness occurring after severe acute respiratory syndrome coronavirus 2 infection in children. As the pandemic progresses, similar syndromes were also reported in adult with a decreased incidence. Multisystem inflammatory syndrome in adults (MIS-A) can be characterized with shock, heart failure, and gastrointestinal symptoms with elevated inflammatory markers after coronavirus disease 2019 (COVID-19) infection. Herein, we describe the first case of MIS-A in South Korea. A 38-year-old man presented to our hospital with a 5-day history of abdominal pain and fever. He had been treated with antibiotics for 5 days at the previous hospital, but symptoms had worsened and he had developed orthopnea on the day of presentation. He suffered COVID-19 six weeks ago. Laboratory data revealed elevated white blood cell counts with neutrophil dominance, C-reactive protein, and B-type natriuretic peptide. Chest X-ray showed normal lung parenchyme and echocardiography showed severe biventricular failure with normal chamber size. We diagnosed him as MIS-A and treated with intravenous immunoglobulin and steroid.

Keyword

COVID-19; Multisystem Inflammatory Syndrome; Adult

Figure

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  Fig. 1 Clinical course and treatment of the patient with multisystem inflammatory syndrome in adults.COVID-19 = coronavirus disease 2019, IVIG = intravenous immunoglobulin, BNP = B-type natriuretic peptide.

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