[COVID-19-associated hyperinflammatory state in a 15-year-old female patient]

Ned Tijdschr Geneeskd. 2020 Oct 22:164:D5348.
[Article in Dutch]

Abstract

Paediatric Multisystem Inflammatory Syndrome Temporally Related to SARS-CoV-2 (PIMS-TS) is a rare novel clinical entity observed in children and adolescents with evidence of a recent COVID-19 infection, and is characterized by a marked hyperinflammatory state with involvement of multiple organ systems.We report a case of a previously healthy 15-year-old female patient, who was admitted to paediatric intensive care with cardiac failure and was subsequently shown to have positive COVID-19 serology. The presenting symptoms were fever, cough, chest pain and gastro-intestinal symptoms. She was supported with milrinone and a low dose of vasopressors. Her hyperinflammatory state was treated with intravenous immunoglobulins, high dose aspirin and high-dose methylprednisolone. PIMS-TS is a rare, potentially life threatening novel clinical entity in children and adolescents with evidence of a COVID-19 infection. Clinicians need to be aware of the possibility of this new disease, to ensure prompt recognition and treatment.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anti-Inflammatory Agents / administration & dosage
  • Aspirin / administration & dosage*
  • COVID-19 Serological Testing / methods
  • COVID-19* / immunology
  • COVID-19* / physiopathology
  • Cardiotonic Agents / administration & dosage
  • Dose-Response Relationship, Drug
  • Female
  • Heart Failure / diagnosis
  • Heart Failure / etiology
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage*
  • Methylprednisolone / administration & dosage*
  • Milrinone / administration & dosage*
  • SARS-CoV-2 / isolation & purification*
  • Systemic Inflammatory Response Syndrome* / immunology
  • Systemic Inflammatory Response Syndrome* / physiopathology
  • Treatment Outcome
  • Vasoconstrictor Agents / administration & dosage*

Substances

  • Anti-Inflammatory Agents
  • Cardiotonic Agents
  • Immunoglobulins, Intravenous
  • Vasoconstrictor Agents
  • Milrinone
  • Aspirin
  • Methylprednisolone

Supplementary concepts

  • pediatric multisystem inflammatory disease, COVID-19 related