Cargando…

Case Report: Guillain–Barré Syndrome Associated With COVID-19

Guillain–Barré syndrome (GBS) is a potentially fatal, immune-mediated disease of the peripheral nervous system that is usually triggered by infection. Only a small number of cases of GBS associated with COVID-19 infection have been published. We report here five patients with GBS admitted to the Neu...

Descripción completa

Detalles Bibliográficos
Autores principales: Khedr, Eman M., Shoyb, Ahmed, Mohamed, Khaled O., Karim, Ahmed A., Saber, Mostafa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258108/
https://www.ncbi.nlm.nih.gov/pubmed/34239495
http://dx.doi.org/10.3389/fneur.2021.678136
_version_ 1783718439333920768
author Khedr, Eman M.
Shoyb, Ahmed
Mohamed, Khaled O.
Karim, Ahmed A.
Saber, Mostafa
author_facet Khedr, Eman M.
Shoyb, Ahmed
Mohamed, Khaled O.
Karim, Ahmed A.
Saber, Mostafa
author_sort Khedr, Eman M.
collection PubMed
description Guillain–Barré syndrome (GBS) is a potentially fatal, immune-mediated disease of the peripheral nervous system that is usually triggered by infection. Only a small number of cases of GBS associated with COVID-19 infection have been published. We report here five patients with GBS admitted to the Neurology, Psychiatry, and Neurosurgery Hospital, Assiut University/Egypt from July 1 to November 20, 2020. Three of the five patients were positive for SARS-CoV-2 following polymerase chain reaction (PCR) of nasopharyngeal swabs on day of admission and another one had a high level of IgM and IgG; all had bilateral ground-glass opacities with consolidation on CT chest scan (GGO) and lymphopenia. All patients presented with two or more of the following: fever, cough, malaise, vomiting, and diarrhea with variable duration. However, there were some peculiarities in the clinical presentation. First, there were only 3 to 14 days between the onset of COVID-19 symptoms and the first symptoms of GBS, which developed into flaccid areflexic quadriplegia with glove and stocking hypoesthesia. The second peculiarity was that three of the cases had cranial nerve involvement, suggesting that there may be a high incidence of cranial involvement in SARS-CoV-2-associated GBS. Other peculiarities occurred. Case 2 presented with a cerebellar hemorrhage before symptoms of COVID-19 and had a cardiac attack with elevated cardiac enzymes following onset of GBS symptoms. Case 5 was also unusual in that the onset began with bilateral facial palsy, which preceded the sensory and motor manifestations of GBS (descending course). Neurophysiological studies showed evidence of sensorimotor demyelinating polyradiculoneuropathy, suggesting acute inflammatory polyneuropathy (AIDP) in all patients. Three patients received plasmapheresis. All of them had either full recovery or partial recovery. Possible pathophysiological links between GBS and COVID-19 are discussed.
format Online
Article
Text
id pubmed-8258108
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-82581082021-07-07 Case Report: Guillain–Barré Syndrome Associated With COVID-19 Khedr, Eman M. Shoyb, Ahmed Mohamed, Khaled O. Karim, Ahmed A. Saber, Mostafa Front Neurol Neurology Guillain–Barré syndrome (GBS) is a potentially fatal, immune-mediated disease of the peripheral nervous system that is usually triggered by infection. Only a small number of cases of GBS associated with COVID-19 infection have been published. We report here five patients with GBS admitted to the Neurology, Psychiatry, and Neurosurgery Hospital, Assiut University/Egypt from July 1 to November 20, 2020. Three of the five patients were positive for SARS-CoV-2 following polymerase chain reaction (PCR) of nasopharyngeal swabs on day of admission and another one had a high level of IgM and IgG; all had bilateral ground-glass opacities with consolidation on CT chest scan (GGO) and lymphopenia. All patients presented with two or more of the following: fever, cough, malaise, vomiting, and diarrhea with variable duration. However, there were some peculiarities in the clinical presentation. First, there were only 3 to 14 days between the onset of COVID-19 symptoms and the first symptoms of GBS, which developed into flaccid areflexic quadriplegia with glove and stocking hypoesthesia. The second peculiarity was that three of the cases had cranial nerve involvement, suggesting that there may be a high incidence of cranial involvement in SARS-CoV-2-associated GBS. Other peculiarities occurred. Case 2 presented with a cerebellar hemorrhage before symptoms of COVID-19 and had a cardiac attack with elevated cardiac enzymes following onset of GBS symptoms. Case 5 was also unusual in that the onset began with bilateral facial palsy, which preceded the sensory and motor manifestations of GBS (descending course). Neurophysiological studies showed evidence of sensorimotor demyelinating polyradiculoneuropathy, suggesting acute inflammatory polyneuropathy (AIDP) in all patients. Three patients received plasmapheresis. All of them had either full recovery or partial recovery. Possible pathophysiological links between GBS and COVID-19 are discussed. Frontiers Media S.A. 2021-06-22 /pmc/articles/PMC8258108/ /pubmed/34239495 http://dx.doi.org/10.3389/fneur.2021.678136 Text en Copyright © 2021 Khedr, Shoyb, Mohamed, Karim and Saber. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Khedr, Eman M.
Shoyb, Ahmed
Mohamed, Khaled O.
Karim, Ahmed A.
Saber, Mostafa
Case Report: Guillain–Barré Syndrome Associated With COVID-19
title Case Report: Guillain–Barré Syndrome Associated With COVID-19
title_full Case Report: Guillain–Barré Syndrome Associated With COVID-19
title_fullStr Case Report: Guillain–Barré Syndrome Associated With COVID-19
title_full_unstemmed Case Report: Guillain–Barré Syndrome Associated With COVID-19
title_short Case Report: Guillain–Barré Syndrome Associated With COVID-19
title_sort case report: guillain–barré syndrome associated with covid-19
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258108/
https://www.ncbi.nlm.nih.gov/pubmed/34239495
http://dx.doi.org/10.3389/fneur.2021.678136
work_keys_str_mv AT khedremanm casereportguillainbarresyndromeassociatedwithcovid19
AT shoybahmed casereportguillainbarresyndromeassociatedwithcovid19
AT mohamedkhaledo casereportguillainbarresyndromeassociatedwithcovid19
AT karimahmeda casereportguillainbarresyndromeassociatedwithcovid19
AT sabermostafa casereportguillainbarresyndromeassociatedwithcovid19