Frontiers in Immunology (Jun 2021)

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

  • Idris Boudhabhay,
  • Idris Boudhabhay,
  • Marion Rabant,
  • Lubka T. Roumenina,
  • Louis-Marie Coupry,
  • Victoria Poillerat,
  • Armance Marchal,
  • Véronique Frémeaux-Bacchi,
  • Khalil El Karoui,
  • Mehran Monchi,
  • Franck Pourcine,
  • Franck Pourcine

DOI
https://doi.org/10.3389/fimmu.2021.680567
Journal volume & issue
Vol. 12

Abstract

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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.

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