Multisystem Inflammatory Syndrome in Adult Following COVID-19 Vaccination (MIS-AV)
Ram Narayanan Ganapathiram, Sonia Hudson
Keywords :
ARDS, COVID-19, Critically ill adults
Citation Information :
Ganapathiram RN, Hudson S. Multisystem Inflammatory Syndrome in Adult Following COVID-19 Vaccination (MIS-AV). Indian J Crit Care Med 2022; 26 (5):649-650.
The last 2 years have been dominated by coronavirus disease-2019 (COVID-19), its various presentations, complications, and their management. The first COVID-19 vaccine, produced by Pfizer-BioNTech, was granted regulatory approval on December 2, 2020, by the UK medicines regulator medicines and healthcare products regulatory agency (MHRA). It was evaluated for emergency use authorization (EUA) status by the US Food and Drug Administration (FDA) and in several other countries. Following millions of doses, during the early months of 2021, reports of side effects of the vaccines began to emerge. In this case report, we discuss the case of a 22-year-old female patient who presented with fever and confusion, with later progression to multiple organ failure, following administration of Pfizer-BioNTech vaccine. She was successfully treated with intravenous (IV) immunoglobulin (Ig) and high-dose IV corticosteroids. This case report is unique as lymph node biopsy was carried out—this showed marked suppurative inflammation with vasculitic changes, thus supporting the diagnosis.
Henderson LA, Canna SW, Schulert GS, Volpi S, Lee PY, Kernan KF, et al. On the alert for cytokine storm: immunopathology in COVID-19. Arthritis Rheumatol 2020;72(7):1059–1063. DOI: 10.1002/art.41285.
Marsh RA. Epstein-Barr virus and hemophagocytic lymphohistiocytosis. Front Immunol 2017;8:1902. DOI: 10.3389/fimmu.2017.01902.
Jain S, Sen S, Lakshmivenkateshiah S, Bobhate P, Venkatesh S, Udani S, et al. Multisystem inflammatory syndrome in children with COVID-19 in Mumbai, India. Indian Pediatr 2020;57(11):1015–1019. DOI: 10.1007/s13312-020-2026-0.
Huang K, Tao S, Zhou X, Mo J, Zhu B, Shen P, et al. Incidence rates of health outcomes of interest among Chinese children exposed to selected vaccines in Yinzhou Electronic Health Records: a population-based retrospective cohort study. Vaccine 2020;38(18):3422–3428. DOI: 10.1016/j.vaccine.2020.03.013.
Baker MA, Baer B, Kulldorff M, Zichittella L, Reindel R, DeLuccia S, et al. Kawasaki disease and 13-valent pneumococcal conjugate vaccination among young children: a self-controlled risk interval and cohort study with null results. PLoS Med 2019;16(7):e1002844. DOI: 10.1371/journal.pmed.1002844.
Phuong LK, Bonetto C, Buttery J, Pernus YB, Chandler R, Felicetti P, et al. Kawasaki disease and immunisation: a systematic review. Vaccine 2017;35(14):1770–1779. DOI: 10.1016/j.vaccine.2016.09.033.
De Nardo P, Bellagamba R, Corpolongo A, Gentilotti E, Taglietti F, Rosati S, et al. Septic shock after seasonal influenza vaccination in an HIV-infected patient during treatment with etanercept for rheumatoid arthritis: a case report. Clin Vaccine Immunol 2013;20(5):761–764. DOI: 10.1128/CVI.00081-13.
Talwar D, Kumar S, Acharya S, Raisinghani N, Madaan S, Hulkoti V, et al. Interleukin 6 and its correlation with COVID-19 in terms of outcomes in an intensive care unit of a rural hospital: a cross-sectional study. Indian J Crit Care Med 2022;26(1):39–42. DOI: 10.5005/jp-journals-10071-24075.
Tendulkar P, Pandey P, Panda PK, Bhadoria AS, Kulshreshtha P. Descriptive epidemiology of COVID-19 deaths during the first wave of pandemic in India: a single-center experience. Indian J Crit Care Med 2022;26(1):71–75. DOI: 10.5005/jp-journals-10071- 24085.
Nune A, Iyengar KP, Goddard C, Ahmed AE. Multisystem inflammatory syndrome in an adult following the SARS-CoV-2 vaccine (MIS-V). BMJ Case Rep 2021;14(7):e243888. DOI: 10.1136/bcr-2021-243888.
