scholarly journals Case Report: Adult Post-COVID-19 Multisystem Inflammatory Syndrome and Thrombotic Microangiopathy

2021 ◽  
Vol 12 ◽  
Author(s):  
Idris Boudhabhay ◽  
Marion Rabant ◽  
Lubka T. Roumenina ◽  
Louis-Marie Coupry ◽  
Victoria Poillerat ◽  
...  
Keyword(s):  
Renal Function ◽  
Case Report ◽  
Thrombotic Microangiopathy ◽  
Therapeutic Option ◽  
Dramatic Improvement ◽  
Case Presentation ◽  
Complement Inhibition ◽  
Clinical Series ◽  
Inflammatory Syndrome

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has affected millions of people worldwide. A clinical series of Kawasaki-like multisystem inflammatory syndrome (MIS), occurring after SARS-CoV-2 infection, have been described in children (MIS-C) and adults (MIS-A), but the pathophysiology remains unknown.Case PresentationWe describe a case of post-COVID-19 MIS-A in a 46-year-old man with biopsy-proven renal thrombotic microangiopathy (TMA). Specific complement inhibition with eculizumab was initiated promptly and led to a dramatic improvement of renal function.ConclusionOur case suggests that that TMA could play a central role in the pathophysiology of post-COVID-19 MIS-A, making complement blockers an interesting therapeutic option.

scholarly journals Adult post COVID-19 multisystem inflammatory syndrome and thrombotic microangiopathy

2020 ◽  
Author(s):  
Idris Boudhabhay ◽  
Marion Rabant ◽  
Louis-Marie Coupry ◽  
Armance Marchal ◽  
Lubka T Roumenina ◽  
...  
Keyword(s):  
Renal Function ◽  
Thrombotic Microangiopathy ◽  
Dramatic Improvement ◽  
Case Presentation ◽  
Complement Inhibition ◽  
Clinical Series ◽  
Long Term Consequences ◽  
Inflammatory Syndrome

Abstract Background: The coronavirus disease 2019 pandemic has affected millions of people worldwide but medium and long-term consequences are unknown. Clinical series of Kawasaki-like multisystem inflammatory syndrome in children (MIS-C), occurring after SARS-Cov-2 spreading, have been recently described. Case presentation: We describe a case of post COVID-19 MIS in a 46-year-old man, with biopsy-proven renal thrombotic microangiopathy (TMA). Specific complement inhibition with Eculizumab was initiated promptly and lead to a dramatic improvement of renal function. Conclusion: Our case suggests that post COVID-19 MIS is not restricted to children and that TMA could play a central role in the pathophysiology of this syndrome

scholarly journals Case Report. Extracorporeal Membrane Oxygenation in Nivolumab Associated Pneumonitis

2017 ◽  
Vol 3 (2) ◽  
pp. 84-88
Author(s):  
Thomas-Michael Schneider ◽  
Friederike Klenner ◽  
Franz Brettner
Keyword(s):  
Case Report ◽  
Extracorporeal Membrane Oxygenation ◽  
Therapeutic Option ◽  
High Dose ◽  
Great Success ◽  
Case Presentation ◽  
Computed Tomographic ◽  
Rehabilitation Hospital ◽  
Membrane Oxygenation ◽  
History Of

Abstract Background: Newly approved immunotherapeutic agents, like CTLA-4 inhibitors and antibodies against PD-1, are a promising therapeutic option in cancer therapy. Case presentation: A 74-year-old man, with a history of advanced stage melanoma and treatment with ipilimumab, pembrolizumab and nivolumab, was admitted to the hospital due to respiratory failure with hypoxemia and dyspnoea. He rapidly developed severe acute respiratory distress syndrome (ARDS), which required treatment in the intensive care unit which included mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Computed tomographic imaging (CT) showed signs of a pneumonitis, with an ARDS pattern related to the use of PD-1 antibodies. Treating the patient with high-dose immunosuppressive steroids led to an overall improvement. He was transferred to a rehabilitation hospital and subsequently to his home. Discussion and conclusion: This is a unique case report of a patient suffering a grade 4 adverse event under nivolumab who survived having been treated with ECMO. It highlights the possibility of associated adverse reactions as well as the use of ECMO in palliative care patients. ECMO can be of great success even in patients with malignancies, but careful decision making should be done on a case by case basis.

scholarly journals Prominent rash and multisystem inflammatory syndrome in a 29-year-old patient with COVID-19: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Catherine A. Gao ◽  
James M. Walter ◽  
Jane E. Dematte D’Amico
Keyword(s):  
Case Report ◽  
Respiratory Symptoms ◽  
Clinical Course ◽  
Adult Patients ◽  
Inflammatory Biomarkers ◽  
Case Presentation ◽  
Hispanic Patient ◽  
Mucosal Changes ◽  
Inflammatory Syndrome ◽  
Disease Present

Abstract Background Adult patients with coronavirus disease present primarily with respiratory symptoms, but children and some adults may display a more systemic inflammatory syndrome with rash, fever, mucosal changes, and elevated inflammatory biomarkers. Case presentation Here, we report the case of a 29-year-old Hispanic patient presenting with significant rash and multisystem inflammation. We describe his clinical course, review dermatological manifestations of coronavirus disease, and summarize the pathophysiology of coronavirus disease-associated multisystem inflammation. Conclusion This case should alert physicians to the atypical nature of presenting rash with minimal respiratory symptoms in coronavirus disease.

scholarly journals Plasma exchange for thrombotic microangiopathy secondary to dermatomyositis associated with acute kidney injury and complement activation: a case report with literature review

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Norifumi Hayashi ◽  
Keiichirou Okada ◽  
Yuko Tsuruyama ◽  
Yu Kagaya ◽  
Sho Kumano ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Intensive Care ◽  
Case Report ◽  
Plasma Exchange ◽  
Complement Activation ◽  
Thrombotic Microangiopathy ◽  
Kidney Injury ◽  
Ivig Therapy ◽  
Case Presentation ◽  
Life Threatening

Abstract Background Thrombotic microangiopathy (TMA) in patients with connective tissue disease is rare but life-threatening. In particular, the survival rate of patients with dermatomyositis (DM) that develop TMA is low. The effectiveness of plasma exchange (PEX) therapy is unclear for the treatment of TMA secondary to DM. Case presentation We describe a case of a 28-year-old woman who developed severe DM complicated by aspiration pneumonia from dysphagia and acute kidney injury. The patient was unresponsive to corticosteroids and intravenous immunoglobulin (IVIG) therapy and developed TMA. In this case, immunofluorescence of skin biopsy revealed that complement activation was involved in the pathogenesis of DM. After 6 PEX therapies, thrombocytopenia improved. She was successfully treated by intensive care and PEX therapy. Conclusions PEX therapy was effective to treat TMA secondary to DM associated with complement activation.

scholarly journals The use of eculizumab in Capnocytophaga canimorsus associated thrombotic microangiopathy: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Magnus Holter Bjørkto ◽  
Andreas Barratt-Due ◽  
Ingvild Nordøy ◽  
Christina Dörje ◽  
Eivind Galteland ◽  
...  
Keyword(s):  
Thrombotic Microangiopathy ◽  
Severe Infection ◽  
Complement Factor ◽  
Disease Entity ◽  
Thrombotic Microangiopathies ◽  
Capnocytophaga Canimorsus ◽  
Factor B ◽  
Case Presentation ◽  
Complement Inhibition ◽  
Diagnostic Difficulties

Abstract Background The use of complement inhibition is well established for complement mediated thrombotic microangiopathy, but its role in secondary forms of thrombotic microangiopathy is debated. We here present a case of thrombotic microangiopathy triggered by Capnocytophaga canimorsus, illustrating the diagnostic difficulties in discriminating between different thrombotic microangiopathies, and the dilemmas regarding how to treat this disease entity. Case presentation A previously healthy 56-year-old woman presented with fever and confusion. She was diagnosed with sepsis from Capnocytophaga canimorsus and thrombotic microangiopathy. Marked activation of both T-cells, endothelium and complement were documented. She was successfully treated with antimicrobial therapy, the complement inhibitor eculizumab and splenectomy. After several weeks, a heterozygote variant in complement factor B was localized, potentially implying the diagnosis of a complement mediated TMA over an isolated infection related TMA. Conclusions We discuss the possible interactions between complement activation and other findings in severe infection and argue that complement inhibition proved beneficial to this patient’s rapid recovery.

scholarly journals Case report: Pediatric patients with COVID-19 presented as multi-system inflammatory syndrome

2020 ◽  
Author(s):  
Amir Saeed ◽  
anahita sanaei ◽  
shabnam Hajiani Ghotbabadi ◽  
Eslam shorafa
Keyword(s):  
Case Report ◽  
Kawasaki Disease ◽  
World Health Organization ◽  
Pediatric Patients ◽  
World Health ◽  
Atypical Presentation ◽  
Case Presentation ◽  
Myocardial Involvement ◽  
Health Organization ◽  
Inflammatory Syndrome

Abstract Background COVID-19 in pediatric patients is typically associated with minimal manifestations and is less severe than adult patients. Recently, there are reports of children with COVID 19 and myocardial involvement from Europe and America that first were assumed to be Kawasaki disease or its atypical presentation. However world health organization has set a new designation for this state; “multi-system involvement syndrome” in children with COVID-19; (MIS-C). Case presentation: Here we report two COVID-19 pediatric patients (two girls aged 10 and 13 years old) with MIS-C. Conclusion Presence of Kawasaki like signs in COVID 19 patients should be an alarming point to consider multi-system inflammatory syndrome; a syndrome with extensive organ involvement and yet indistinct exact pathophysiology.

scholarly journals Trichrome-positive intrahepatic cytoplasmic globules are potential histopathological clue for COVID-19-induced hepatitis: a case report

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dina Sweed ◽  
Mohamed Ramadan El Shanshory ◽  
Eman Mohammed Elaskary ◽  
Hassnaa Atef Hassan ◽  
Enas Sweed ◽  
...  
Keyword(s):  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Liver Biopsy ◽  
Respiratory System ◽  
Hepatitis A ◽  
Liver Enzymes ◽  
Dramatic Improvement ◽  
Case Presentation ◽  
Elevated Liver Enzymes ◽  
History Of

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection mainly affects respiratory system. Later, liver affection has also been reported in the form of marked elevated liver enzymes. However, the association of coronavirus disease-19 (COVID-19) and autoimmune diseases is not clear. Case presentation A female patient with a known history of autoimmune hemolytic anemia (AIHH) for which she was treated with prednisolone was admitted for uncontrolled anemia followed by fever and elevated liver enzymes. All the laboratory and radiological investigations were not typical for COVID-19 or any other etiology. Liver biopsy revealed numerous pale eosinophilic trichrome-positive intracytoplasmic globules. The pathology raised the suspicion for SARS-CoV-2-associated hepatitis, which was confirmed by a positive IgG titer. The patient showed a dramatic improvement on the maintenance dose of prednisolone. Conclusions AIHA patients co-infected with SARS-CoV-2 may be at risk of uncontrolled disease and should continue their treatment regimen. Histopathology has a role in the diagnosis of liver affection due to SARS-CoV-2 infection.

scholarly journals A case of coinfection of a pediatric patient with acute SARS-COV-2 with MIS-C and severe DENV-2 in Mexico: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Perez-Mendez Maria Jose ◽  
Zarate-Segura Paola ◽  
Davila-Gonzalez Eduardo ◽  
Servin-Monroy Monroy Osvaldo Arturo ◽  
Bastida-Gonzalez Fernando
Keyword(s):  
Case Report ◽  
Pediatric Patients ◽  
Distress Syndrome ◽  
Fluid Overload ◽  
Severe Thrombocytopenia ◽  
Coronary Artery Ectasia ◽  
Case Presentation ◽  
Clinical Symptomatology ◽  
Effusion Fluid ◽  
Inflammatory Syndrome

Abstract Background COVID-19 cases have been increasing since the epidemic started. One of the major concerns is how clinical symptomatology would behave after coinfection with another virus. Case presentation In this case report, a pediatric native patient from Estado de Mexico (EDOMEX), MEX had severe DENV-2 and acute SARS-CoV-2 at the same time. The clinical features were severe thrombocytopenia, secondary septic shock, cerebral edema, pericardial effusion, fluid overload that exhibited bipalpebral edema in all four extremities, hemophagocytic lymphohistiocytosis (HLH), coronary artery ectasia (CAE), multisystemic inflammatory syndrome in children (MIS-C), and probable COVID-19 pneumonia or acute respiratory distress syndrome (ARDS) that triggered patient intubation. The patient presented unusual symptomatology according to the literature. After 15 days of intubation and 15 more days under surveillance, he was released without respiratory sequelae and without treatment after major clinical improvement. Conclusion The aim of this manuscript is to present clinical challenges that coinfection may cause in pediatric patients, even though COVID-19 in children does not tend to be as severe as in other sectors of the population.

scholarly journals COVID-19 Could Trigger Systemic Juvenile Idiopathic Arthritis: First Case Report

2020 ◽  
Author(s):  
Vadood Javadi Parvaneh ◽  
Khosro Rahmani
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Case Report ◽  
Acute Abdomen ◽  
Systemic Juvenile Idiopathic Arthritis ◽  
Signs And Symptoms ◽  
The Body ◽  
Case Presentation ◽  
Systemic Jia ◽  
First Case ◽  
Inflammatory Syndrome

Abstract Background: COVID-19 has been reported to cause a variety of signs and symptoms during its three known phases.Case presentation: We report a 7 years-old boy with COVID-19 first presented with an acute abdomen. Then he showed pictures of Kawasaki-like syndrome, a multiorgan inflammatory syndrome in children (MIS-C), and finally systemic juvenile idiopathic arthritis.Conclusion: MIS-C is a result of the hyperinflammatory response of the body to SARS-CoV-2. Although there are increasing reports of this state in children, we reported the first case presenting systemic JIA triggered by COVID-19.

scholarly journals Arthroscopic evaluation and treatment of a squeaking hip. A case report

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Jonathan Bellity ◽  
Marc Elkaïm ◽  
Didier Hannouche ◽  
Rémy Nizard
Keyword(s):  
Case Report ◽  
Total Hip Arthroplasty ◽  
Hip Arthroscopy ◽  
Hip Replacement ◽  
Therapeutic Option ◽  
Fibrous Tissue ◽  
Ceramic Fracture ◽  
Case Presentation ◽  
Sliding Surfaces ◽  
Ceramic On Ceramic

Abstract Background Squeaking of ceramic-on-ceramic total hip arthroplasty is an unexpected complication which occurs in 1- 30% of patients. Revision surgery is required in 0.2% of the cases, when a ceramic fracture is suspected, or in case of severe malposition of the implants, subluxation, or impingement. Hip arthroscopy may be a useful diagnostic and therapeutic option in squeaking hips. Case presentation A patient presenting with a pain-free squeaking underwent hip arthroscopy to examine the sliding surfaces and the rim of the acetabulum, and to search for signs of impingement. Thorough lavage and debridement of hip synovitis and fibrous tissue was performed. The squeaking noise immediately disappeared after the surgery. The patient was allowed to fully weight bear as tolerated with 2 crutches for 2 weeks. Two years after the arthroscopy, the patient remained symptom-free. Conclusions The potential reasons for hip squeaking in our patient are discussed. Hip arthroscopy may prove useful as a diagnostic and therapeutic option for some patients presenting with a squeaking ceramic-on ceramic hip replacement.

Sign in / Sign up

Export Citation Format

Share Document