tetano
Editor, Senior Moderator
J Med Virol
. 2021 Apr 14.
doi: 10.1002/jmv.27018. Online ahead of print.
Axonal Guillain-Barre syndrome associated with SARS-CoV-2 infection in a child
Nihal Ak?ay[SUP] 1 [/SUP], Mehmet Emin Meneto?lu[SUP] 1 [/SUP], Gonca Bekta?[SUP] 2 [/SUP], Esra ?evketo?lu[SUP] 1 [/SUP]
Affiliations
Abstract
Background: The relation between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and demyelinating Guillain Barre Syndrome (GBS) has been defined. We aim to report the clinical features of a child with axonal GBS associated with SARS-CoV-2.
Case: A 6-year-old male presented with symmetric ascending paralysis progressed over a 4-day course and 2-day of fever. He had bilateral lower and upper limb flaccid weakness of 1/5 with absent deep tendon reflexes. He had severe respiratory muscle weakness requiring invasive mechanical ventilation. On admission, SARS-CoV-2 returned as positive by real-time polymerase chain reaction on a nasopharyngeal swab. Cerebrospinal fluid analysis showed elevated protein without pleocytosis. He was diagnosed with GBS associated with SARS-CoV-2 infection. The nerve conduction study was suggestive of acute motor axonal neuropathy. Ten consecutive therapeutic plasma exchange sessions with 5% albumin replacement followed by four sessions on alternate days were performed. On day 12, methylprednisolone (30 mg/kg/day for 5 days) was given. On day 18, intravenous immunoglobulin (IVIG) (2 g/kg/day) was given and repeated 14 days after due to severe motor weakness. On day 60, he was discharged from the hospital with weakness of neck flexor and extensor muscles of 3/5 and the upper limbs and the lower limbs of 2/5 on home-ventilation.
Conclusion: Our patient is considered to be the youngest patient presenting with a possible para-infectious association between axonal GBS and SARS-CoV-2 infection. The disease course was severe with a rapid progression, an earlier peak, and prolonged duration in weakness as expected in axonal GBS This article is protected by copyright. All rights reserved.
. 2021 Apr 14.
doi: 10.1002/jmv.27018. Online ahead of print.
Axonal Guillain-Barre syndrome associated with SARS-CoV-2 infection in a child
Nihal Ak?ay[SUP] 1 [/SUP], Mehmet Emin Meneto?lu[SUP] 1 [/SUP], Gonca Bekta?[SUP] 2 [/SUP], Esra ?evketo?lu[SUP] 1 [/SUP]
Affiliations
- PMID: 33851741
- DOI: 10.1002/jmv.27018
Abstract
Background: The relation between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and demyelinating Guillain Barre Syndrome (GBS) has been defined. We aim to report the clinical features of a child with axonal GBS associated with SARS-CoV-2.
Case: A 6-year-old male presented with symmetric ascending paralysis progressed over a 4-day course and 2-day of fever. He had bilateral lower and upper limb flaccid weakness of 1/5 with absent deep tendon reflexes. He had severe respiratory muscle weakness requiring invasive mechanical ventilation. On admission, SARS-CoV-2 returned as positive by real-time polymerase chain reaction on a nasopharyngeal swab. Cerebrospinal fluid analysis showed elevated protein without pleocytosis. He was diagnosed with GBS associated with SARS-CoV-2 infection. The nerve conduction study was suggestive of acute motor axonal neuropathy. Ten consecutive therapeutic plasma exchange sessions with 5% albumin replacement followed by four sessions on alternate days were performed. On day 12, methylprednisolone (30 mg/kg/day for 5 days) was given. On day 18, intravenous immunoglobulin (IVIG) (2 g/kg/day) was given and repeated 14 days after due to severe motor weakness. On day 60, he was discharged from the hospital with weakness of neck flexor and extensor muscles of 3/5 and the upper limbs and the lower limbs of 2/5 on home-ventilation.
Conclusion: Our patient is considered to be the youngest patient presenting with a possible para-infectious association between axonal GBS and SARS-CoV-2 infection. The disease course was severe with a rapid progression, an earlier peak, and prolonged duration in weakness as expected in axonal GBS This article is protected by copyright. All rights reserved.