Immune and coagulation profiles in 3 adults with multisystem inflammatory syndrome
Annals of the Academy of Medicine, Singapore
;
: 80-87, 2023.
Article
in English
| WPRIM
| ID: wpr-970014
ABSTRACT
INTRODUCTION@#There is a paucity of information on the cytokine, complement, endothelial activation, and coagulation profiles of multisystem inflammatory syndrome in adults (MIS-A), a rare but serious complication following recovery from SARS-CoV-2 infection. We aim to examine the immune biomarker and coagulation profiles in association with the clinical presentation and course of MIS-A.@*METHOD@#The clinical features of MIS-A patients admitted to our tertiary hospital were documented. Their levels of interleukin (IL)-1β, IL-6, IL-10, IL-17, IL-18, interferon-α (IFN-α), IFN-γ, interferon gamma-induced protein 10 (IP-10), tumour necrosis factor (TNF)-α, monocyte chemoattractant protein (MCP)-1, complement activation product (complement 5a [C5a]), and endothelial biomarker intercellular adhesion molecule-1 (ICAM-1) levels were assayed. The haemostatic profile was assessed with standard coagulation testing and thromboelastography.@*RESULTS@#Three male patients were diagnosed with MIS-A at our centre from January to June 2022 with a median age of 55 years. All had tested positive for SARS-CoV-2 12-62 days prior to MIS-A presentation, with gastrointestinal and cardiovascular systems as the most commonly involved. Levels of IL-6, IL-10, IL-18, IP-10 and MCP-1 were raised whereas IL-1β, IFN-α, IFN-γ, IL-17 and TNF-α remained normal. Markedly elevated levels of C-reactive protein (CRP), ferritin and ICAM-1 were present in all. C5a was elevated in 2 patients. A hypercoagulable state was demonstrated by raised levels of D-dimer, factor VIII, von Willebrand factor antigen, and ristocetin cofactor with corresponding raised parameters in thromboelastography in the 2 patients who had their coagulation profile assessed.@*CONCLUSION@#MIS-A patients demonstrate activation of pro-inflammatory cytokines, endotheliopathy, complement hyperactivation and hypercoagulability.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Hemostatics
/
Interleukin-6
/
Interleukin-10
/
Intercellular Adhesion Molecule-1
/
Connective Tissue Diseases
/
Interleukin-17
/
Interleukin-18
/
Chemokine CXCL10
/
SARS-CoV-2
/
COVID-19
Limits:
Adult
/
Humans
/
Male
Language:
English
Journal:
Annals of the Academy of Medicine, Singapore
Year:
2023
Type:
Article
Similar
MEDLINE
...
LILACS
LIS