Successful Use of Granulocyte and Monocyte Adsorptive Apheresis in a Patient with Post-COVID-19 Multisystem Inflammatory Syndrome in Adults

Shuzo Kaneko; Tsuyoshi Zen; Susumu Banjoya; Toshiaki Nuki; Ainori Hoshimoto; Makiko Harano; Sou Hagiwara; Eri Imai; Yusuke Tsukamoto

doi:10.2169/internalmedicine.1728-23

CASE REPORTS

Successful Use of Granulocyte and Monocyte Adsorptive Apheresis in a Patient with Post-COVID-19 Multisystem Inflammatory Syndrome in Adults

Shuzo Kaneko, Tsuyoshi Zen, Susumu Banjoya, Toshiaki Nuki, Ainori Hoshimoto, Makiko Harano, Sou Hagiwara, Eri Imai, Yusuke Tsukamoto

Author information

Shuzo Kaneko
Department of Nephrology, Itabashi Chuo Medical Center, Japan
Tsuyoshi Zen
Department of Nephrology, Itabashi Chuo Medical Center, Japan
Susumu Banjoya
Department of Gastroenterology, Itabashi Chuo Medical Center, Japan
Toshiaki Nuki
Department of Cardiology, Itabashi Chuo Medical Center, Japan
Ainori Hoshimoto
Department of Nephrology, Itabashi Chuo Medical Center, Japan
Makiko Harano
Department of Nephrology, Itabashi Chuo Medical Center, Japan
Sou Hagiwara
Department of Nephrology, Itabashi Chuo Medical Center, Japan
Eri Imai
Department of Nephrology, Itabashi Chuo Medical Center, Japan
Yusuke Tsukamoto
Department of Nephrology, Itabashi Chuo Medical Center, Japan

Keywords: COVID-19, granulocyte and monocyte adsorptive apheresis, multisystem inflammatory syndrome in adults, MIS-A, myocarditis, pericarditis

JOURNAL OPEN ACCESS

2023 Volume 62 Issue 17 Pages 2565-2569

DOI https://doi.org/10.2169/internalmedicine.1728-23

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Abstract

Multisystem inflammatory syndrome in adults (MIS-A) is a life-threatening disease that can develop weeks after coronavirus disease 2019 (COVID-19). MIS-A symptoms include multiorgan involvement, especially gastrointestinal tract and heart involvement, and Kawasaki disease-like symptoms. We herein report a 44-year-old Japanese man with MIS-A who had contracted COVID-19 five weeks ago and went into shock after acute gastroenteritis, acute kidney injury, and Kawasaki disease-like symptoms. Methylprednisone pulse and high-dose intravenous immunoglobulin resulted in recovery of shock and his renal function, but diffuse ST-segment elevation on electrocardiography and pericardial effusion with a fever emerged after therapy. Additional granulocyte-monocyte adsorptive apheresis successfully ameliorated the cardiac involvement.

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