{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T23:06:22Z","timestamp":1783724782798,"version":"3.55.0"},"reference-count":12,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,6,15]]},"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:p>Multisystem inflammatory syndrome in adults (MIS-A) is an uncommon and under-recognised postinfectious manifestation that presents 4\u20136 weeks after COVID-19 infection. Patients affected tend to be young or middle-aged, from ethnic minority backgrounds and previously healthy. In addition to high fever and myalgia, there are a myriad of extrapulmonary symptoms and signs, including cardiac, gastrointestinal, neurological and dermatological involvement. Cardiovascular shock and markedly raised inflammatory markers are prominent features, while significant hypoxia is uncommon. Patients respond well to corticosteroid therapy, but failure of clinicians to recognise this recently identified phenomenon, which can mimic common conditions including sepsis, could delay diagnosis and treatment. Here we present a case of MIS-A in an adult woman, compare her presentation and management with other similar case reports, and reflect on how clinicians can learn from our experiences.<\/jats:p>","DOI":"10.1136\/bcr-2021-243114","type":"journal-article","created":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T10:35:23Z","timestamp":1633084523000},"page":"e243114","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Adult presentation of multisystem inflammatory syndrome (MIS) associated with recent COVID-19 infection: lessons learnt in timely diagnosis and management"],"prefix":"10.1136","volume":"14","author":[{"given":"Qiang","family":"Yao","sequence":"first","affiliation":[{"name":"Broomfield Hospital, Mid and South Essex NHS Foundation Trust, Chelmsford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Waley","sequence":"additional","affiliation":[{"name":"King's College Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"Liou","sequence":"additional","affiliation":[{"name":"Barts Health NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,10,1]]},"reference":[{"key":"2025082708020649000_14.10.e243114.1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6940e1"},{"key":"2025082708020649000_14.10.e243114.2","article-title":"Adult inflammatory multi-system syndrome mimicking Kawasaki disease in a patient with COVID-19","volume":"12","author":"Malangu","year":"2020","journal-title":"Cureus"},{"key":"2025082708020649000_14.10.e243114.3","article-title":"A case of multisystem inflammatory syndrome Post-COVID-19 infection in an adult","volume":"12","author":"Ahsan","year":"2020","journal-title":"Cureus"},{"key":"2025082708020649000_14.10.e243114.4","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-020-05439-z"},{"key":"2025082708020649000_14.10.e243114.5","doi-asserted-by":"crossref","DOI":"10.1177\/2324709620974200","article-title":"A 23-year-old man with multisystem inflammatory syndrome after mild COVID-19","volume":"8","author":"Razavi","year":"2020","journal-title":"J Investig Med High Impact Case Rep"},{"key":"2025082708020649000_14.10.e243114.6","doi-asserted-by":"crossref","first-page":"253.e1","DOI":"10.1016\/j.ajem.2020.06.053","article-title":"COVID-19 associated Kawasaki-like multisystem inflammatory disease in an adult","volume":"39","author":"Sokolovsky","year":"2021","journal-title":"Am J Emerg Med"},{"key":"2025082708020649000_14.10.e243114.7","doi-asserted-by":"crossref","first-page":"e520","DOI":"10.1016\/S2665-9913(20)30234-4","article-title":"An adult presentation consistent with PIMS-TS","volume":"2","author":"Jones","year":"2020","journal-title":"Lancet Rheumatol"},{"key":"2025082708020649000_14.10.e243114.8","doi-asserted-by":"crossref","unstructured":"Flower L , Gale A , Elfar E , et al . O01\u2003Adult onset PIMS-TS with secondary haemophagocytic lymphistiocytosis: into the eye of the cytokine storm. Rheumatol Adv Pract 2020;4.doi:10.1093\/rap\/rkaa053","DOI":"10.1093\/rap\/rkaa053"},{"key":"2025082708020649000_14.10.e243114.9","doi-asserted-by":"crossref","first-page":"3293","DOI":"10.3390\/jcm9103293","article-title":"Presentation, treatment response and short-term outcomes in paediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 (PIMS-TS)","volume":"9","author":"Felsenstein","year":"2020","journal-title":"J Clin Med"},{"key":"2025082708020649000_14.10.e243114.10","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30221-0"},{"key":"2025082708020649000_14.10.e243114.11","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s00296-020-04749-4","article-title":"Severe COVID-19, multisystem inflammatory syndrome in children, and Kawasaki disease: immunological mechanisms, clinical manifestations and management","volume":"41","author":"Kabeerdoss","year":"2021","journal-title":"Rheumatol Int"},{"key":"2025082708020649000_14.10.e243114.12","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30651-4"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-243114","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:02:11Z","timestamp":1756306931000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-243114"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10]]},"references-count":12,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,10,1]]},"published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1136\/bcr-2021-243114"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-243114","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10]]}}}