Case Report: Lymphohistiocytic Myocarditis With Severe Cardiogenic Shock Requiring Mechanical Cardiocirculatory Support in Multisystem Inflammatory Syndrome Following SARS-CoV-2 Infection
Multisystem Inflammatory Syndrome (MIS) is a novel hyperinflammatory syndrome associated with SARS-CoV-2 infection. It predominantly affects children (MIS-C) a few weeks after a usually asymptomatic SARS-CoV-2 infection and is only rarely seen in adults above 21 years (MIS-A). Only scarce data on hi...
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Frontiers Media S.A.
2021-09-01
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Series: | Frontiers in Cardiovascular Medicine |
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Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.716198/full |
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doaj-8cbc773134b94a9094ba5f5838757738 |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Xavier Bemtgen Xavier Bemtgen Karin Klingel Markus Hufnagel Ales Janda Christoph Bode Christoph Bode Dawid L. Staudacher Dawid L. Staudacher Alexander Supady Alexander Supady Alexander Supady Ilona Jandova |
spellingShingle |
Xavier Bemtgen Xavier Bemtgen Karin Klingel Markus Hufnagel Ales Janda Christoph Bode Christoph Bode Dawid L. Staudacher Dawid L. Staudacher Alexander Supady Alexander Supady Alexander Supady Ilona Jandova Case Report: Lymphohistiocytic Myocarditis With Severe Cardiogenic Shock Requiring Mechanical Cardiocirculatory Support in Multisystem Inflammatory Syndrome Following SARS-CoV-2 Infection Frontiers in Cardiovascular Medicine COVID-19 V-A ECMO Impella® MIS-C Multisystem Inflammatory Syndrome in children myocardial biopsy |
author_facet |
Xavier Bemtgen Xavier Bemtgen Karin Klingel Markus Hufnagel Ales Janda Christoph Bode Christoph Bode Dawid L. Staudacher Dawid L. Staudacher Alexander Supady Alexander Supady Alexander Supady Ilona Jandova |
author_sort |
Xavier Bemtgen |
title |
Case Report: Lymphohistiocytic Myocarditis With Severe Cardiogenic Shock Requiring Mechanical Cardiocirculatory Support in Multisystem Inflammatory Syndrome Following SARS-CoV-2 Infection |
title_short |
Case Report: Lymphohistiocytic Myocarditis With Severe Cardiogenic Shock Requiring Mechanical Cardiocirculatory Support in Multisystem Inflammatory Syndrome Following SARS-CoV-2 Infection |
title_full |
Case Report: Lymphohistiocytic Myocarditis With Severe Cardiogenic Shock Requiring Mechanical Cardiocirculatory Support in Multisystem Inflammatory Syndrome Following SARS-CoV-2 Infection |
title_fullStr |
Case Report: Lymphohistiocytic Myocarditis With Severe Cardiogenic Shock Requiring Mechanical Cardiocirculatory Support in Multisystem Inflammatory Syndrome Following SARS-CoV-2 Infection |
title_full_unstemmed |
Case Report: Lymphohistiocytic Myocarditis With Severe Cardiogenic Shock Requiring Mechanical Cardiocirculatory Support in Multisystem Inflammatory Syndrome Following SARS-CoV-2 Infection |
title_sort |
case report: lymphohistiocytic myocarditis with severe cardiogenic shock requiring mechanical cardiocirculatory support in multisystem inflammatory syndrome following sars-cov-2 infection |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Cardiovascular Medicine |
issn |
2297-055X |
publishDate |
2021-09-01 |
description |
Multisystem Inflammatory Syndrome (MIS) is a novel hyperinflammatory syndrome associated with SARS-CoV-2 infection. It predominantly affects children (MIS-C) a few weeks after a usually asymptomatic SARS-CoV-2 infection and is only rarely seen in adults above 21 years (MIS-A). Only scarce data on histological findings in both pediatric and adult patients has been published so far. An 18-year-old male patient was admitted to hospital in a febrile state, which progressed to severe cardiogenic shock and multi-organ failure requiring extracorporeal life support. Myocardial biopsy revealed small vessel-associated immune cell infiltrates. Diagnosis of MIS-C was made after ruling out all potential differential diagnosis. Use of immunosuppressive treatment with steroids, interleukin-1 blockade and high-dose intravenous immunoglobulins resulted in the patient's full recovery. Multisystem Inflammatory Syndrome (MIS) is a new differential diagnosis of cardiac dysfunction in pediatric and adult patients. The lack of myocardial necrosis differentiates the disease from other viral myocarditis and offers an explanation for the fast response to immunomodulatory therapy and the favorable prognosis. The preceding SARS-CoV-2 infection might only have been mildly symptomatic or even asymptomatic. |
topic |
COVID-19 V-A ECMO Impella® MIS-C Multisystem Inflammatory Syndrome in children myocardial biopsy |
url |
https://www.frontiersin.org/articles/10.3389/fcvm.2021.716198/full |
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doaj-8cbc773134b94a9094ba5f58387577382021-09-09T07:52:38ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-09-01810.3389/fcvm.2021.716198716198Case Report: Lymphohistiocytic Myocarditis With Severe Cardiogenic Shock Requiring Mechanical Cardiocirculatory Support in Multisystem Inflammatory Syndrome Following SARS-CoV-2 InfectionXavier Bemtgen0Xavier Bemtgen1Karin Klingel2Markus Hufnagel3Ales Janda4Christoph Bode5Christoph Bode6Dawid L. Staudacher7Dawid L. Staudacher8Alexander Supady9Alexander Supady10Alexander Supady11Ilona Jandova12Department of Cardiology and Angiology I (Heart Center Freiburg – Bad Krozingen), University Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, GermanyDepartment of Medicine III (Interdisciplinary Medical Intensive Care), University Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, GermanyCardiopathology, Institute for Pathology and Neuropathology, University Hospital Tübingen, Tübingen, GermanyDepartment of Pediatrics and Adolescent Medicine, University Medical Center, Medical Faculty, University of Freiburg, Freiburg, GermanyDepartment of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, GermanyDepartment of Cardiology and Angiology I (Heart Center Freiburg – Bad Krozingen), University Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, GermanyDepartment of Medicine III (Interdisciplinary Medical Intensive Care), University Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, GermanyDepartment of Cardiology and Angiology I (Heart Center Freiburg – Bad Krozingen), University Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, GermanyDepartment of Medicine III (Interdisciplinary Medical Intensive Care), University Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, GermanyDepartment of Cardiology and Angiology I (Heart Center Freiburg – Bad Krozingen), University Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, GermanyDepartment of Medicine III (Interdisciplinary Medical Intensive Care), University Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, GermanyHeidelberg Institute of Global Health, University of Heidelberg, Heidelberg, GermanyDepartment of Rheumatology and Clinical Immunology, University Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, GermanyMultisystem Inflammatory Syndrome (MIS) is a novel hyperinflammatory syndrome associated with SARS-CoV-2 infection. It predominantly affects children (MIS-C) a few weeks after a usually asymptomatic SARS-CoV-2 infection and is only rarely seen in adults above 21 years (MIS-A). Only scarce data on histological findings in both pediatric and adult patients has been published so far. An 18-year-old male patient was admitted to hospital in a febrile state, which progressed to severe cardiogenic shock and multi-organ failure requiring extracorporeal life support. Myocardial biopsy revealed small vessel-associated immune cell infiltrates. Diagnosis of MIS-C was made after ruling out all potential differential diagnosis. Use of immunosuppressive treatment with steroids, interleukin-1 blockade and high-dose intravenous immunoglobulins resulted in the patient's full recovery. Multisystem Inflammatory Syndrome (MIS) is a new differential diagnosis of cardiac dysfunction in pediatric and adult patients. The lack of myocardial necrosis differentiates the disease from other viral myocarditis and offers an explanation for the fast response to immunomodulatory therapy and the favorable prognosis. The preceding SARS-CoV-2 infection might only have been mildly symptomatic or even asymptomatic.https://www.frontiersin.org/articles/10.3389/fcvm.2021.716198/fullCOVID-19V-A ECMOImpella®MIS-CMultisystem Inflammatory Syndrome in childrenmyocardial biopsy |