Abstract | December 20, 2022

A Case Report of Multisystem Inflammatory Syndrome 9 Days after First-dose COVID-19 Vaccination

Presenting Author: Sanhitha Valasareddy, MD, Internal Medicine Resident PGY3, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee

Coauthors: Hieu VO, MD, Nephrology, Assistant Professor

Learning Objectives

  1. Identify key components of Multisystem Inflammatory Syndrome in Adults.

Introduction: Multisystem Inflammatory Syndrome in Adults (MIS-A) is a novel sequelae thought to be related to the COVID-19 virus. Not many risk factors have been proven to be identified for MIS-A and it is difficult to predict which patients would be most likely to get this inflammatory response. Factors that are in question include: race, obesity, and vaccination status. 

 

Case presentation: We present the case of a 22-year-old African-American male who developed multisystem inflammatory syndrome 9 days after receiving his first dose of COVID-19 Pfizer vaccine.  The patient originally had the COVID-19 virus in July 2021 and tested positive again 3 days after receiving the first dose. Patient did have multiple elevated inflammatory markers. Interleukin-6 was elevated at 18.5. 

 

Final Working Diagnosis: Our patient met all five criteria that the CDC defined as MIS-A1: he presented with an objective fever, was hospitalized for a week with multiple organ dysfunctions, had a positive rapid COVID test, he had several inflammatory markers that were positive (including IL-6, lactic acid, D-dimer, CRP, ferritin, and procalcitonin), and had an absence of a concomitant severe respiratory illness and did not require any oxygenation after the first day of hospitalization. 

 

Outcome: Treatments, including IVIG and steroids, were done with full recovery of the patient ,and he was discharged after 7 days in the hospital. Relationships between MIS-A and vaccination rates along with previous COVID-19 infection rates need to be examined further to determine any sources of causation. There are only a handful of case reports available where MIS-A occurs after vaccination. Not enough is known about predisposing factors and the appropriate treatment strategies and universal guidelines are needed as cases continue to rise.

 

References:

  1. Cattaneo P, Volpe A, Cardellino CS, Riccardi N, Bertoli G, Ursini T, Ustalli A, Lodi G, Daroui I, Angheben A. Multisystem Inflammatory Syndrome in an Adult (MIS-A) Successfully Treated with Anakinra and Glucocorticoids. Microorganisms. 2021 Jun 28;9(7):1393. doi: 10.3390/microorganisms9071393. PMID: 34203277; PMCID: PMC8305807.

 

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