Multisystem Inflammatory Syndrome-Adult: A Rare Presentation of Infection by SARS-CoV-2
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.24950/rspmi.501 |
Resumo: | Among the manifestations of COVID-19, we find multisystem inflammatory syndrome (MIS), characterized by a hyperinflammatory state in which multiorgan dysfunction occurs. A 22-years-old woman came to the emergency department with dry cough, myalgias, rash and fever for 3 days. PCR for SARS-CoV-2 was positive. Admitted to hospital on day 5 of disease due to symptomatic worsening. She had lesions in erythematous-violaceous plaques on the trunk, thighs and back of the hands. On day 7 of disease, clinical worsening, so a computed tomography scan was performed revealing findings compatible with renal, splenic and hepatic hypoperfusion. Echocardiogram showed systolic dysfunction due to global hypocontractility (LVEF 25%-30%). MIS-A was admitted, with cutaneous, gastrointestinal and cardiac involvement. She was treated with human immunoglobulin, methylprednisolone and diuretics, with progressive clinical improvement and recovery of cardiac function. Contrary to the more common severe forms of SARS-CoV-2 infection, in which pulmonary involvement prevails, in this syndrome the respiratory involvement is often mild, making it a diagnostic challenge. |
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Multisystem Inflammatory Syndrome-Adult: A Rare Presentation of Infection by SARS-CoV-2Síndrome de Resposta Inflamatória Multissistémica do Adulto: Uma Apresentação Rara da Infeção Por SARS-CoV-2COVID-19ExantemaInsuficiência CardíacaSARS-CoV-2Síndrome de Resposta Inflamatória MultissistémicaCOVID-19/complicationsExanthemaHeart FailureSARS-CoV-2Systemic Inflammatory Response SyndromeAmong the manifestations of COVID-19, we find multisystem inflammatory syndrome (MIS), characterized by a hyperinflammatory state in which multiorgan dysfunction occurs. A 22-years-old woman came to the emergency department with dry cough, myalgias, rash and fever for 3 days. PCR for SARS-CoV-2 was positive. Admitted to hospital on day 5 of disease due to symptomatic worsening. She had lesions in erythematous-violaceous plaques on the trunk, thighs and back of the hands. On day 7 of disease, clinical worsening, so a computed tomography scan was performed revealing findings compatible with renal, splenic and hepatic hypoperfusion. Echocardiogram showed systolic dysfunction due to global hypocontractility (LVEF 25%-30%). MIS-A was admitted, with cutaneous, gastrointestinal and cardiac involvement. She was treated with human immunoglobulin, methylprednisolone and diuretics, with progressive clinical improvement and recovery of cardiac function. Contrary to the more common severe forms of SARS-CoV-2 infection, in which pulmonary involvement prevails, in this syndrome the respiratory involvement is often mild, making it a diagnostic challenge.Entre as demais manifestações da COVID-19, encontramos a síndrome inflamatória multissistémica (MIS), que se caracteriza por um estado hiperinflamatório em que ocorre disfunção multiorgânica. Mulher, 22 anos, recorreu ao serviço de urgência (SU) por quadro de tosse seca, mialgias, exantema e febre com 3 dias de evolução. A pesquisa de PCR para SARS-CoV-2 positiva. Admitida em internamento em dia 5 de doença por agravamento sintomático. Apresentava lesões em placas eritemato-violáceas no tronco, coxas e dorso das mãos. Em dia 7 de doença, agravamento clínico, pelo que realizou tomografia computorizada revelando achados compatíveis com hipoperfusão renal, esplénica e hepática. Ecocardiograma mostrou disfunção sistólica por hipocontratilidade global (FEVE 25%-30%). Admitiu-se síndrome inflamatória multissistémica do adulto (MIS-A), com envolvimento cutâneo, gastrointestinal e cardíaco. Cumpriu terapêutica com imunoglobulina humana, metilprednisolona e diuréticos, com progressiva melhoria clínica e recuperação da função cardíaca. Contrariamente às formas graves mais comuns de infeção por SARS-CoV-2, em que o envolvimento pulmonar impera, nesta síndrome o acometimento respiratório é frequentemente ligeiro, tornando-a um desafio diagnóstico.Sociedade Portuguesa de Medicina Interna2022-12-19info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.24950/rspmi.501https://doi.org/10.24950/rspmi.501Internal Medicine; Vol. 29 No. 4 (2022): Outubro/Dezembro; 272-277Medicina Interna; Vol. 29 N.º 4 (2022): Outubro/Dezembro; 272-2772183-99800872-671Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revista.spmi.pt/index.php/rpmi/article/view/501https://revista.spmi.pt/index.php/rpmi/article/view/501/923Direitos de Autor (c) 2022 Medicina Internainfo:eu-repo/semantics/openAccessGomes, DoraDuarte, DanielaOliveira, CatarinaVaz, AlexandraCapelo, JoanaAlmeida, Inês2023-01-07T06:10:34Zoai:oai.revista.spmi.pt:article/501Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:28:51.691301Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Multisystem Inflammatory Syndrome-Adult: A Rare Presentation of Infection by SARS-CoV-2 Síndrome de Resposta Inflamatória Multissistémica do Adulto: Uma Apresentação Rara da Infeção Por SARS-CoV-2 |
title |
Multisystem Inflammatory Syndrome-Adult: A Rare Presentation of Infection by SARS-CoV-2 |
spellingShingle |
Multisystem Inflammatory Syndrome-Adult: A Rare Presentation of Infection by SARS-CoV-2 Gomes, Dora COVID-19 Exantema Insuficiência Cardíaca SARS-CoV-2 Síndrome de Resposta Inflamatória Multissistémica COVID-19/complications Exanthema Heart Failure SARS-CoV-2 Systemic Inflammatory Response Syndrome |
title_short |
Multisystem Inflammatory Syndrome-Adult: A Rare Presentation of Infection by SARS-CoV-2 |
title_full |
Multisystem Inflammatory Syndrome-Adult: A Rare Presentation of Infection by SARS-CoV-2 |
title_fullStr |
Multisystem Inflammatory Syndrome-Adult: A Rare Presentation of Infection by SARS-CoV-2 |
title_full_unstemmed |
Multisystem Inflammatory Syndrome-Adult: A Rare Presentation of Infection by SARS-CoV-2 |
title_sort |
Multisystem Inflammatory Syndrome-Adult: A Rare Presentation of Infection by SARS-CoV-2 |
author |
Gomes, Dora |
author_facet |
Gomes, Dora Duarte, Daniela Oliveira, Catarina Vaz, Alexandra Capelo, Joana Almeida, Inês |
author_role |
author |
author2 |
Duarte, Daniela Oliveira, Catarina Vaz, Alexandra Capelo, Joana Almeida, Inês |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Gomes, Dora Duarte, Daniela Oliveira, Catarina Vaz, Alexandra Capelo, Joana Almeida, Inês |
dc.subject.por.fl_str_mv |
COVID-19 Exantema Insuficiência Cardíaca SARS-CoV-2 Síndrome de Resposta Inflamatória Multissistémica COVID-19/complications Exanthema Heart Failure SARS-CoV-2 Systemic Inflammatory Response Syndrome |
topic |
COVID-19 Exantema Insuficiência Cardíaca SARS-CoV-2 Síndrome de Resposta Inflamatória Multissistémica COVID-19/complications Exanthema Heart Failure SARS-CoV-2 Systemic Inflammatory Response Syndrome |
description |
Among the manifestations of COVID-19, we find multisystem inflammatory syndrome (MIS), characterized by a hyperinflammatory state in which multiorgan dysfunction occurs. A 22-years-old woman came to the emergency department with dry cough, myalgias, rash and fever for 3 days. PCR for SARS-CoV-2 was positive. Admitted to hospital on day 5 of disease due to symptomatic worsening. She had lesions in erythematous-violaceous plaques on the trunk, thighs and back of the hands. On day 7 of disease, clinical worsening, so a computed tomography scan was performed revealing findings compatible with renal, splenic and hepatic hypoperfusion. Echocardiogram showed systolic dysfunction due to global hypocontractility (LVEF 25%-30%). MIS-A was admitted, with cutaneous, gastrointestinal and cardiac involvement. She was treated with human immunoglobulin, methylprednisolone and diuretics, with progressive clinical improvement and recovery of cardiac function. Contrary to the more common severe forms of SARS-CoV-2 infection, in which pulmonary involvement prevails, in this syndrome the respiratory involvement is often mild, making it a diagnostic challenge. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-12-19 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.24950/rspmi.501 https://doi.org/10.24950/rspmi.501 |
url |
https://doi.org/10.24950/rspmi.501 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://revista.spmi.pt/index.php/rpmi/article/view/501 https://revista.spmi.pt/index.php/rpmi/article/view/501/923 |
dc.rights.driver.fl_str_mv |
Direitos de Autor (c) 2022 Medicina Interna info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Direitos de Autor (c) 2022 Medicina Interna |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Medicina Interna |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Medicina Interna |
dc.source.none.fl_str_mv |
Internal Medicine; Vol. 29 No. 4 (2022): Outubro/Dezembro; 272-277 Medicina Interna; Vol. 29 N.º 4 (2022): Outubro/Dezembro; 272-277 2183-9980 0872-671X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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