Volume 28, Number 4—April 2022
Research Letter
Multisystem Inflammatory Syndrome in Adult after First Dose of mRNA Vaccine
Yusuke Miyazato, Kei Yamamoto
, Gen Yamada, Shuji Kubota, Masahiro Ishikane, Masaya Sugiyama, Mikako Ueno, Akihiro Matsunaga, Tohru Miyoshi-Akiyama, Yukihito Ishizaka, and Norio Ohmagari
, Gen Yamada, Shuji Kubota, Masahiro Ishikane, Masaya Sugiyama, Mikako Ueno, Akihiro Matsunaga, Tohru Miyoshi-Akiyama, Yukihito Ishizaka, and Norio Ohmagari
Table
Clinical features and laboratory results of a patient who experienced multisystem inflammatory syndrome in an adult after a coronavirus vaccination, Japan, 2021
| Characteristic | Hospital day 1 | Hospital day 2 | Hospital day 3 | Hospital day 5 | Day of discharge (day 8) | 1 month after discharge | Reference range |
|---|---|---|---|---|---|---|---|
| Clinical features | |||||||
| Maximum body temperature, °C | 38.1 | 39.1 | 36.8 | 36.8 | 36.8 | 36.0 | NA |
| Maximum respiratory rate, breaths/min | 20 | 35 | 26 | 22 | 18 | NA | NA |
| Maximum heart rate, bpm | 126 | 128 | 120 | 111 | 100 | NA | NA |
| Minimum blood pressure, mm Hg |
102/81 |
105/85 |
113/88 |
141/85 |
135/85 |
NA |
NA |
| Laboratory results | |||||||
| SARS-CoV-2 real-time PCR | Negative | NA | NA | NA | NA | NA | Negative |
| SARS-CoV-2 spike IgG | Positive | NA | NA | NA | NA | Positive (day 19) | Negative |
| SARS-CoV-2 nucleocapsid IgG | Positive | NA | NA | NA | NA | NA | Negative |
| Leukocytes, cells/µL | 12,790 | 16,330 | 14,280 | 13,380 | 17,680 | 4,780 | 3,300–8,600 |
| Platelets, × 103/µL | 166 | 217 | 240 | 294 | 341 | 208 | 158–348 |
| Creatinine, mg/dL | 1.02 | 1.14 | 1.26 | 1.09 | 0.95 | 1.07 | 0.65–1.07 |
| LDH, U/L | 210 | 228 | 225 | 227 | 214 | 213 | 124–222 |
| Troponin I, ng/mL | 0.371 | 1.102 | 1.306 | 0.295 | 0.094 | NA | 0–0.026 |
| BNP, pg/mL | 129.3 | 409.5 | NA | NA | 68.0 | NA | 0–18.4 |
| CRP, mg/dL | 30.73 | 35.82 | 33.34 | 10.35 | 1.98 | 0.08 | 0–0.14 |
| Ferritin, ng/mL | 880.0 | NA | NA | NA | NA | NA | 21–282 |
| ESR, mm/h | NA | NA | NA | NA | 49 | NA | 2–10 |
| IL-6, pg/mL |
NA |
NA |
NA |
99.29 |
0 (day 9) |
0 (day 44) |
0 |
| Treatment | |||||||
| Oxygen delivery devices | Nasal cannula | NIV | NIV | Nasal cannula | None | None | NA |
| Corticosteroids | None | mPSL 125 mg/d (1 mg/kg/d) IV | mPSL 125 mg/d (1 mg/kg/d) IV | PSL 60 mg orally | None | None | NA |
| Diuretics | Furosemide 20 mg orally | Furosemide 40 mg IV | Furosemide 40 mg IV | Furosemide 20 mg orally | None | None | NA |
| Antimicrobial drugs | LVFX 500 mg orally | LVFX 500 mg orally | None | None | None | None | NA |
*BNP, brain natriuretic peptide; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; IL-6, interleukin-6; IV, intravenous; IgG, immunoglobulin G; LDH, lactate dehydrogenase; LVFX, levofloxacin; mPSL, methylprednisolone; NA, not applicable; NIV, noninvasive ventilation; PSL, predonisolone; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.
Page created: February 11, 2022
Page updated: March 19, 2022
Page reviewed: March 19, 2022
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