Case report: Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 with severe myocardial dysfunction. Is there any hope in immunotherapy?

TOKAREK, Julita, BUDNY, Emilian & SZMIGIELSKA, Renata. Case report: Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 with severe myocardial dysfunction. Is there any hope in immunotherapy? Journal of Education, Health and Sport. 2023;26(1):27-30. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2023.26.01.003 https://apcz.umk.pl/JEHS/article/view/43330 https://zenodo.org/record/7896304 The journal has had 40 points in Ministry of Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Education and Science of December 21, 2021. No. 32343. Has a Journal's Unique Identifier: 201159. Scientific disciplines assigned: Physical Culture Sciences (Field of Medical sciences and health sciences); Health Sciences (Field of Medical Sciences and Health Sciences). Punkty Ministerialne z 2019 - aktualny rok 40 punktów. Załącznik do komunikatu Ministra Edukacji i Nauki z dnia 21 grudnia 2021 r. Lp. 32343. Posiada Unikatowy Identyfikator Czasopisma: 201159. Przypisane dyscypliny naukowe: Nauki o kulturze fizycznej (Dziedzina nauk medycznych i nauk o zdrowiu); Nauki o zdrowiu (Dziedzina nauk medycznych i nauk o zdrowiu). © The Authors 2023; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 29.03.2023. Revised: 20.04.2023. Accepted: 04.05.2023. Published: 04.05.2023. Case report: Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 with severe myocardial dysfunction. Is there any hope in immunotherapy? Julita Tokarek Medical University of Lodz https://orcid.org/0000-0003-4527-3355 Emilian Budny Medical University of Lodz https://orcid.org/0009-0006-7737-5689 Renata Szmigielska Medical University of Lodz https://orcid.org/0000-0002-3528-6139 Abstract Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) develops in a small percentage of children after COVID-19, however, it might cause severe myocardial dysfunction. The pathogenesis of this disease includes systemic hyper-inflammation with cytokine storm. This case report concerns a 12-year-old boy with PIMS-TS who presented severe respiratory and circulatory failure with increased inflammatory markers and significant reduction of left ventricle ejaculatory fraction (LVEF) from 65% to 35%. The recommended therapy with the use of vasopressors, corticosteroids, intravenous immunoglobulins and mechanical ventilation was introduced and his condition gradually improved. However, after few days, aggravation of cardiac symptoms occurred again and among other treatment, the therapy with the use of anakinra - the human interleukin 1 receptor antagonist protein was introduced. This case highlights a satisfactory regression of cardiac disturbances and generally favorable outcome of the treatment in patients with PIMS-TS with the use of immunomodulatory therapy. Keywords: COVID-19, PIMS-TS, anakinra, immunomodulatory therap