心筋障害により心不全を呈した小児多系統炎症性症候群（MIS-C）の１例

抄録

Multisystem Inflammatory Syndrome in Children (MIS-C) is a new disease that develops after coronavirus disease 2019 (COVID-19) and is known to cause severe inflammation in multiple organs, gastrointestinal symptoms, respiratory distress, and shock.
The patient was an 8-year-old boy who developed MIS-C one month after COVID-19 and presented with left ventricular systolic dysfunction and hypotension. Prednisolone (PSL) and high-dose immunoglobulin therapy (IVIG) improved some symptoms and part of the laboratory findings, but ferritin and D-dimer remained elevated, suggesting a cytokine storm. After infliximab (IFX) administration, ferritin and D-dimer improved, suggesting that IFX may be useful in suppressing cytokines that were not suppressed by the combination of PSL and IVIG. NT-proBNP and troponin T were elevated the day before shock and decreased with improvement in left ventricular contractility. We suggest that measurement of NT-proBNP and troponin T help in early prediction of shock in MIS-C.