key: cord-304533-qwbbsg14
authors: Jones, Imogen; Bell, Lucy C K; Manson, Jessica J; Last, Anna
title: An adult presentation consistent with PIMS-TS
date: 2020-07-10
journal: Lancet Rheumatol
DOI: 10.1016/s2665-9913(20)30234-4
sha: 
doc_id: 304533
cord_uid: qwbbsg14

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The patient had no previous his tory of COVID19 symptoms or con tact with known COVID19 cases. Nasopharyngeal and stool samples were negative for SARSCoV2 by PCR. Other infective and inflammatory conditions were excluded (appendix p 2). Adult and paediatric specialists conferred and concluded that the most likely diagnosis was Kawasaki like disease on the PIMSTS spectrum. The patient was treated with intra venous immunoglobulin and methyl prednisolone, which resulted in rapid resolution of symptoms and normalisation of blood parameters (appendix p 3); he was discharged on lowdose aspirin 8 days after admission to hospital.

SARSCoV2 serology 3 (checked before treatment with intravenous immuno globulin) was strongly posi tive, suggesting recent exposure to SARSCoV2 (appendix p 2). Kawasaki dis ease has been described in adults in association with viral infection. 4, 5 To the best of our knowledge, this is the first reported case of adult Kawasaki like disease related to SARSCoV2 infection. There is an urgent need to recognise and fully characterise PIMS TS in young adults to improve our understanding of pathogenesis, guide treatment decisions, and prevent sequelae in these patients.

Hyperinflammatory shock in children during COVID19 pandemic

An outbreak of severe Kawasakilike disease at the Italian epicentre of SARSCoV2 epidemic: an observational cohort study

Preexisting and de novo humoral immunity to SARSCoV2 in humans

A case of complete adultonset Kawasaki disease: a review of pathogenesis and classification

Kawasakilike syndromes in HIVinfected adults