tetano
Editor, Senior Moderator
Pediatr Infect Dis J
. 2021 Aug 12.
doi: 10.1097/INF.0000000000003295. Online ahead of print.
COVID-19-ASSOCIATED ACUTE DISSEMINATED ENCEPHALOMYELITIS-LIKE DISEASE IN 2 CHILDREN
Nihal Akçay[SUP] 1 [/SUP], Gonca Bektaş, Mehmet Emin Menentoğlu, Mustafa Oğur, Ayşe İrem Sofuoğlu, Figen Bakirtaş Palabiyik, Esra Şevketoğlu
Affiliations
Abstract
Background: The coronavirus disease 2019 pandemic was caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although the predominant clinical presentation is a respiratory disease, neurological manifestations are being recognized increasingly.
Case report: We report 2 children aged 9 years old who developed acute disseminated encephalomyelitis-like disease associated with SARS-CoV-2. Seizures and encephalopathy were the main central nervous system symptoms. The cerebrospinal fluid analysis performed within the first week of disease onset showed elevated protein in both children with normal cell count and no evidence of infection including negative SARS-CoV-2 by antibody and polymerase chain reaction. Brain magnetic resonance imaging revealed T2A, fluid-attenuated inversion recovery cortical and subcortical hyperintensity without restricted diffusion consistent with acute disseminated encephalomyelitis-like disease. They received methylprednisolone followed by therapeutic plasma exchange. One of them showed complete clinical improvement and resolution in magnetic resonance imaging findings. The other developed laminar necrosis in brain magnetic resonance imaging and showed significant clinical improvement after therapeutic plasma exchange. He was positive for positive SARS-CoV-2 antibody in cerebrospinal fluid on day 55 of admission. They were both positive for SARS-CoV-2 antibodies in serum after 2 weeks.
Conclusions: Our two cases highlight the occurrence of acute disseminated encephalomyelitis-like disease as a postinfectious/immune-mediated complication of SARS-CoV-2 infection.
. 2021 Aug 12.
doi: 10.1097/INF.0000000000003295. Online ahead of print.
COVID-19-ASSOCIATED ACUTE DISSEMINATED ENCEPHALOMYELITIS-LIKE DISEASE IN 2 CHILDREN
Nihal Akçay[SUP] 1 [/SUP], Gonca Bektaş, Mehmet Emin Menentoğlu, Mustafa Oğur, Ayşe İrem Sofuoğlu, Figen Bakirtaş Palabiyik, Esra Şevketoğlu
Affiliations
- PMID: 34387618
- DOI: 10.1097/INF.0000000000003295
Abstract
Background: The coronavirus disease 2019 pandemic was caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although the predominant clinical presentation is a respiratory disease, neurological manifestations are being recognized increasingly.
Case report: We report 2 children aged 9 years old who developed acute disseminated encephalomyelitis-like disease associated with SARS-CoV-2. Seizures and encephalopathy were the main central nervous system symptoms. The cerebrospinal fluid analysis performed within the first week of disease onset showed elevated protein in both children with normal cell count and no evidence of infection including negative SARS-CoV-2 by antibody and polymerase chain reaction. Brain magnetic resonance imaging revealed T2A, fluid-attenuated inversion recovery cortical and subcortical hyperintensity without restricted diffusion consistent with acute disseminated encephalomyelitis-like disease. They received methylprednisolone followed by therapeutic plasma exchange. One of them showed complete clinical improvement and resolution in magnetic resonance imaging findings. The other developed laminar necrosis in brain magnetic resonance imaging and showed significant clinical improvement after therapeutic plasma exchange. He was positive for positive SARS-CoV-2 antibody in cerebrospinal fluid on day 55 of admission. They were both positive for SARS-CoV-2 antibodies in serum after 2 weeks.
Conclusions: Our two cases highlight the occurrence of acute disseminated encephalomyelitis-like disease as a postinfectious/immune-mediated complication of SARS-CoV-2 infection.