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Paracentral acute middle maculopathy in Susac syndrome after dual exposure to SARS-CoV-2 antigen

We report a case of Susac syndrome after SARS-CoV-2 infection and subsequent vaccination that presented with meningitis and retinal microembolisation in the form of paracentral acute middle maculopathy (PAMM). After presenting with headache, fever and myalgia followed by scotomata, a woman in her 50...

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Autores principales: Malerbi, Fernando Korn, Schoeps, Vinicius Andreoli, T F Matos, Kimble
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9092144/
https://www.ncbi.nlm.nih.gov/pubmed/35537770
http://dx.doi.org/10.1136/bcr-2021-247159
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author Malerbi, Fernando Korn
Schoeps, Vinicius Andreoli
T F Matos, Kimble
author_facet Malerbi, Fernando Korn
Schoeps, Vinicius Andreoli
T F Matos, Kimble
author_sort Malerbi, Fernando Korn
collection PubMed
description We report a case of Susac syndrome after SARS-CoV-2 infection and subsequent vaccination that presented with meningitis and retinal microembolisation in the form of paracentral acute middle maculopathy (PAMM). After presenting with headache, fever and myalgia followed by scotomata, a woman in her 50s was hospitalised for meningitis; she had had mild COVID-19 infection 2 months prior to admission, having received the first vaccine dose 1 month prior to the neurological manifestation. Eye fundus examination and optical coherence tomography were suggestive of PAMM. D-dimer levels and erythrocyte sedimentation rate were elevated. Before infectious investigation results were available, she was started on empirical antibiotic and antiviral treatment. Having ruled out infectious causes, she was started on high-dose prednisolone. After 1 month, there was partial resolution of retinal lesions. This case highlights that exposure to SARS-CoV-2 antigen may be related to this rare syndrome; treatment with steroids may improve central and retinal impairment.
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spelling pubmed-90921442022-05-27 Paracentral acute middle maculopathy in Susac syndrome after dual exposure to SARS-CoV-2 antigen Malerbi, Fernando Korn Schoeps, Vinicius Andreoli T F Matos, Kimble BMJ Case Rep Case Reports: Unusual association of diseases/symptoms We report a case of Susac syndrome after SARS-CoV-2 infection and subsequent vaccination that presented with meningitis and retinal microembolisation in the form of paracentral acute middle maculopathy (PAMM). After presenting with headache, fever and myalgia followed by scotomata, a woman in her 50s was hospitalised for meningitis; she had had mild COVID-19 infection 2 months prior to admission, having received the first vaccine dose 1 month prior to the neurological manifestation. Eye fundus examination and optical coherence tomography were suggestive of PAMM. D-dimer levels and erythrocyte sedimentation rate were elevated. Before infectious investigation results were available, she was started on empirical antibiotic and antiviral treatment. Having ruled out infectious causes, she was started on high-dose prednisolone. After 1 month, there was partial resolution of retinal lesions. This case highlights that exposure to SARS-CoV-2 antigen may be related to this rare syndrome; treatment with steroids may improve central and retinal impairment. BMJ Publishing Group 2022-05-10 /pmc/articles/PMC9092144/ /pubmed/35537770 http://dx.doi.org/10.1136/bcr-2021-247159 Text en © BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.
spellingShingle Case Reports: Unusual association of diseases/symptoms
Malerbi, Fernando Korn
Schoeps, Vinicius Andreoli
T F Matos, Kimble
Paracentral acute middle maculopathy in Susac syndrome after dual exposure to SARS-CoV-2 antigen
title Paracentral acute middle maculopathy in Susac syndrome after dual exposure to SARS-CoV-2 antigen
title_full Paracentral acute middle maculopathy in Susac syndrome after dual exposure to SARS-CoV-2 antigen
title_fullStr Paracentral acute middle maculopathy in Susac syndrome after dual exposure to SARS-CoV-2 antigen
title_full_unstemmed Paracentral acute middle maculopathy in Susac syndrome after dual exposure to SARS-CoV-2 antigen
title_short Paracentral acute middle maculopathy in Susac syndrome after dual exposure to SARS-CoV-2 antigen
title_sort paracentral acute middle maculopathy in susac syndrome after dual exposure to sars-cov-2 antigen
topic Case Reports: Unusual association of diseases/symptoms
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9092144/
https://www.ncbi.nlm.nih.gov/pubmed/35537770
http://dx.doi.org/10.1136/bcr-2021-247159
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