Successful Use of Granulocyte and Monocyte Adsorptive Apheresis in a Patient with Post-COVID-19 Multisystem Inflammatory Syndrome in Adults

• Published in: Internal Medicine Vol. 62; no. 17; pp. 2565 - 2569
• Main Authors: Kaneko, Shuzo, Zen, Tsuyoshi, Banjoya, Susumu, Nuki, Toshiaki, Hoshimoto, Ainori, Harano, Makiko, Hagiwara, Sou, Imai, Eri, Tsukamoto, Yusuke
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.09.2023; Japan Science and Technology Agency
• Subjects: Apheresis; Case Report; Coronaviruses; COVID-19; Effusion; EKG; Gastroenteritis; Gastrointestinal tract; granulocyte and monocyte adsorptive apheresis; Heart diseases; Inflammation; Internal medicine; Leukocytes (granulocytic); MIS-A; Monocytes; Mucocutaneous lymph node syndrome; multisystem inflammatory syndrome in adults; myocarditis; pericarditis; Renal function; COVID-19; multisystem inflammatory syndrome in adults; granulocyte and monocyte adsorptive apheresis; MIS-A; pericarditis; myocarditis
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.1728-23

Multisystem inflammatory syndrome in adults (MIS-A) is a life-threatening disease that can develop weeks after coronavirus disease 2019 (COVID-19). MIS-A symptoms include multiorgan involvement, especially gastrointestinal tract and heart involvement, and Kawasaki disease-like symptoms. We herein report a 44-year-old Japanese man with MIS-A who had contracted COVID-19 five weeks ago and went into shock after acute gastroenteritis, acute kidney injury, and Kawasaki disease-like symptoms. Methylprednisone pulse and high-dose intravenous immunoglobulin resulted in recovery of shock and his renal function, but diffuse ST-segment elevation on electrocardiography and pericardial effusion with a fever emerged after therapy. Additional granulocyte-monocyte adsorptive apheresis successfully ameliorated the cardiac involvement.