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Case Reports: Unusual association of diseases/symptoms
Severe myopathy complicating multisystem inflammatory syndrome in adults (MIS-A) in a young man
  1. Alessandro E. Costa,
  2. Nadine S. Bernasconi,
  3. Marten Trendelenburg and
  4. Max J. Schunemann
  1. Division of Internal Medicine, University Hospital Basel, Basel, Switzerland
  1. Correspondence to Dr Max J. Schunemann; max.schuenemann{at}usb.ch

Abstract

We report the case of a man in his early 30s who presented with high fever, cervical lymphadenopathy, maculopapular rash and considerably elevated inflammatory markers. Further evaluations revealed cardiomyopathy and renal failure. During hospitalisation he developed profound generalised muscle weakness caused by diffuse myopathy without elevated creatine kinase. He was eventually diagnosed with multisystem inflammatory syndrome in adults (MIS-A) after it was established that he had been suffering from COVID-19 5 weeks prior to presentation. He was started on intravenous immunoglobulins and high-dose corticosteroids, after which symptoms resolved rapidly. MIS-A is a rare but severe complication of COVID-19, whose pathogenesis is insufficiently understood. This case provides further insight into this new disease entity by describing a previously unreported disease progression with severe inflammatory myopathy without elevated creatine kinase.

  • COVID-19
  • Immunology

https://doi.org/10.1136/bcr-2022-250054

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    Footnotes

    • Contributors AEC wrote the first draft of the manuscript together with NSB and implemented all changes. He was the junior doctor primarily involved in the patient’s care. NSB wrote the first draft of the manuscript together with AEC and was involved in the patient’s care. MT gave critical input in the revision process and was involved in the patient’s care. MJS critically revised the manuscript and was the consultant on the ward.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.