Multisystem Inflammatory Syndrome in an Adult (MIS-A) Successfully Treated with Anakinra and Glucocorticoids

被引：21

作者：

Cattaneo, Paolo ^{[1
,2
]}

Volpe, Alessandro ^{[3
]}

Cardellino, Chiara Simona ^{[1
]}

Riccardi, Niccolo ^{[1
]}

Bertoli, Giulia ^{[1
]}

Ursini, Tamara ^{[1
]}

Ustalli, Arjola ^{[4
]}

Lodi, Giovanni ^{[5
]}

Daroui, Ivan ^{[5
]}

Angheben, Andrea ^{[1
]}

机构：

[1] IRCCS Sacro Cuore Don Calabria Hosp, Dept Infect Trop Dis & Microbiol, I-37024 Negrar Di Valpolicella, Italy

[2] Univ Verona, Dept Diagnost & Publ Hlth, Div Infect Dis, I-37129 Verona, Italy

[3] IRCCS Sacro Cuore Don Calabria Hosp, Rheumatol Unit, I-37024 Negrar Di Valpolicella, Italy

[4] IRCCS Sacro Cuore Don Calabria Hosp, Pneumol Unit, I-37024 Negrar Di Valpolicella, Italy

[5] IRCCS Sacro Cuore Don Calabria Hosp, Intens Care Unit, I-37024 Negrar Di Valpolicella, Italy

来源：

MICROORGANISMS | 2021年 / 9卷 / 07期

关键词：

anakinra; COVID-19; MIS-A; multisystem inflammatory syndrome; SARS-CoV-2;

D O I：

10.3390/microorganisms9071393

中图分类号：

Q93 [微生物学];

学科分类号：

071005 ; 100705 ;

摘要：

During the current SARS-CoV-2 pandemic, a novel syndrome termed "multisystem inflammatory syndrome in children" (MIS-C) has emerged. MIS-C was linked to COVID-19 and shared some features with Kawasaki disease and Toxic Shock Syndrome, with a common pathogenetic substrate of hyperinflammation and cytokine storm. Lately, MIS was also described in adults (>= 21 years of age) and named "MIS-A". There is no consensus about the treatment of MIS-A; successful use of glucocorticoids and immunoglobulins has been reported in case series, but more solid evidence is lacking. Furthermore, the role of biologic agents with proven benefits against COVID-19, MIS-C, or Kawasaki disease is still unexplored. In this report, we detail the clinical picture and the diagnostic process that led to the diagnosis of MIS-A in a 27-year-old man, focusing on its treatment with anakinra and glucocorticoids, which resulted in full recovery. To our knowledge, this is the first report of the successful use of anakinra for MIS-A, a drug that has already proven useful in the treatment of refractive cases of MIS-C. Anakinra may also play a pivotal role for the treatment of MIS-A.

引用

页数：6

共 16 条

[1] Immunological memory to SARS-CoV-2 assessed for up to 8 months after infection [J].

Dan, Jennifer M. ;

Mateus, Jose ;

Kato, Yu ;

Hastie, Kathryn M. ;

Yu, Esther Dawen ;

Faliti, Caterina E. ;

Grifoni, Alba ;

Ramirez, Sydney, I ;

Haupt, Sonya ;

Frazier, April ;

Nakao, Catherine ;

Rayaprolu, Vamseedhar ;

Rawlings, Stephen A. ;

Peters, Bjoern ;

Krammer, Florian ;

Simon, Viviana ;

Saphire, Erica Ollmann ;

Smith, Davey M. ;

Weiskopf, Daniela ;

Sette, Alessandro ;

Crotty, Shane .

SCIENCE, 2021, 371 (6529) :587-+

[2] Case Report: Use of Anakinra in Multisystem Inflammatory Syndrome During COVID-19 Pandemic [J].

Della Paolera, Sara ;

Valencic, Erica ;

Piscianz, Elisa ;

Moressa, Valentina ;

Tommasini, Alberto ;

Sagredini, Raffaella ;

Kiren, Valentina ;

Comar, Manola ;

Taddio, Andrea .

FRONTIERS IN PEDIATRICS, 2021, 8

[3] Case Report: Case Series of Children With Multisystem Inflammatory Syndrome Following SARS-CoV-2 Infection in Switzerland [J].

Fouriki, Athina ;

Fougere, Yves ;

De Camaret, Caroline ;

Blanchard Rohner, Geraldine ;

Grazioli, Serge ;

Wagner, Noemie ;

Relly, Christa ;

Pachlopnik Schmid, Jana ;

Truck, Johannes ;

Kottanatu, Lisa ;

Perez, Estefania ;

Perez, Marie-Helene ;

Schaffner, Damien ;

Asner, Sandra Andrea ;

Hofer, Michael .

FRONTIERS IN PEDIATRICS, 2021, 8

[4] Anakinra after treatment with corticosteroids alone or with tocilizumab in patients with severe COVID-19 pneumonia and moderate hyperinflammation. A retrospective cohort study [J].

Francisco Aomar-Millan, Ismael ;

Salvatierra, Juan ;

Torres-Parejo, Ursula ;

Faro-Miguez, Naya ;

Luis Callejas-Rubio, Jose ;

Ceballos-Torres, Angel ;

Teresa Cruces-Moreno, Maria ;

Javier Gomez-Jimenez, Francisco ;

Hernandez-Quero, Jose ;

Anguita-Santos, Francisco .

INTERNAL AND EMERGENCY MEDICINE, 2021, 16 (04) :843-852

[5]

Gaebler C, 2021, NATURE, V591, P639, DOI [10.1038/s41586-021-03207-w, 10.1101/2020.11.03.367391]

[6] Coronavirus Disease 2019 Acute Myocarditis and Multisystem Inflammatory Syndrome in Adult Intensive and Cardiac Care Units [J].

Hekimian, Guillaume ;

Kerneis, Mathieu ;

Zeitouni, Michel ;

Cohen-Aubart, Fleur ;

Chommeloux, Juliette ;

Brechot, Nicolas ;

Mathian, Alexis ;

Lebreton, Guillaume ;

Schmidt, Matthieu ;

Hie, Miguel ;

Silvain, Johanne ;

de Chambrun, Marc Pineton ;

Haroche, Julien ;

Burrel, Sonia ;

Marot, Stephane ;

Luyt, Charles-Edouard ;

Leprince, Pascal ;

Amoura, Zahir ;

Montalescot, Gilles ;

Redheuil, Alban ;

Combes, Alain .

CHEST, 2021, 159 (02) :657-662

[7] COVID-19 and multisystem inflammatory syndrome in children and adolescents [J].

Jiang, Li ;

Tang, Kun ;

Levin, Mike ;

Irfan, Omar ;

Morris, Shaun K. ;

Wilson, Karen ;

Klein, Jonathan D. ;

Bhutta, Zulfiqar A. .

LANCET INFECTIOUS DISEASES, 2020, 20 (11) :E276-E288

[8] A young adult with COVID-19 and multisystem inflammatory syndrome in children (MIS-C)-like illness: a case report [J].

Kofman, Aaron D. ;

Sizemore, Emma K. ;

Detelich, Joshua F. ;

Albrecht, Benjamin ;

Piantadosi, Anne L. .

BMC INFECTIOUS DISEASES, 2020, 20 (01)

[9] An open label trial of anakinra to prevent respiratory failure in COVID-19 [J].

Kyriazopoulou, Evdoxia ;

Panagopoulos, Periklis ;

Metallidis, Symeon ;

Dalekos, George N. ;

Poulakou, Garyphallia ;

Gatselis, Nikolaos ;

Karakike, Eleni ;

Saridaki, Maria ;

Loli, Georgia ;

Stefos, Aggelos ;

Prasianaki, Danai ;

Georgiadou, Sarah ;

Tsachouridou, Olga ;

Petrakis, Vasileios ;

Tsiakos, Konstantinos ;

Kosmidou, Maria ;

Lygoura, Vassiliki ;

Dareioti, Maria ;

Milionis, Haralampos ;

Papanikolaou, Ilias C. ;

Akinosoglou, Karolina ;

Myrodia, Dimitra-Melia ;

Gravvani, Areti ;

Stamou, Aliki ;

Gkavogianni, Theologia ;

Katrini, Konstantina ;

Marantos, Theodoros ;

Trontzas, Ioannis P. ;

Syrigos, Konstantinos ;

Chatzis, Loukas ;

Chatzis, Stamatios ;

Vechlidis, Nikolaos ;

Avgoustou, Christina ;

Chalvatzis, Stamatios ;

Kyprianou, Miltiades ;

van der Meer, Jos Wm ;

Eugen-Olsen, Jesper ;

Netea, Mihai G. ;

Giamarellos-Bourboulis, Evangelos J. .

ELIFE, 2021, 10

[10] Effect of anakinra versus usual care in adults in hospital with COVID-19 and mild-to-moderate pneumonia (CORIMUNO-ANA-1): a randomised controlled trial [J].

Mariette, Xavier ;

Hermine, Olivier ;

Tharaux, Pierre Louis ;

Resche-Rigon, Matthieu ;

Porcher, Raphael ;

Ravaud, Philippe ;

Bureau, Serge ;

Dougados, Maxime ;

Tibi, Annick .

LANCET RESPIRATORY MEDICINE, 2021, 9 (03) :295-304

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