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Concomitant Guillain-Barre syndrome with COVID-19: a case report
Nuvia Mackenzie1, Eva Lopez-Coronel1, Alberto Dau1
1Center for Clinical and Translational Research, La Misericordia Clínica Internacional, Barranquilla, Colombia.
Insights
This case study reports the first confirmed instance of Guillain-Barre syndrome (GBS) co-occurring with Coronavirus disease 2019 (COVID-19) in Colombia. The findings highlight a potential neurological complication of SARS-CoV-2 infection requiring further investigation.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Neurological manifestations are increasingly recognized during the Coronavirus disease 2019 (COVID-19) pandemic.
- Guillain-Barre syndrome (GBS), a rare autoimmune disorder, has been infrequently reported in association with COVID-19.
- This study aims to document the first confirmed case of concomitant GBS and COVID-19 in Colombia.
Observation:
- A 39-year-old woman presented with progressive weakness, facial diplegia, and quadriparesis following symptoms of ageusia, anosmia, and headache.
- Clinical progression included areflexia, hypertensive emergency, and diaphragmatic weakness, necessitating intensive care unit admission.
- Cerebrospinal fluid analysis revealed protein-cytological dissociation, and nerve conduction studies confirmed GBS. SARS-CoV-2 testing was positive.
Findings:
- The patient exhibited classic signs and diagnostic markers of GBS.
- The diagnosis of GBS was confirmed through cerebrospinal fluid analysis and electrodiagnostic testing.
- The patient recovered with supportive care after a 20-day hospitalization.
Implications:
- This case contributes to the limited understanding of GBS as a potential neurological complication of COVID-19.
- It underscores the need for further research into the association between SARS-CoV-2 infection and immune-mediated neurological disorders.
- Investigating the mechanisms of immune-mediated nerve tissue destruction in GBS post-COVID-19 is crucial.
Background:
During the Coronavirus disease 2019 (COVID-19) pandemic, different neurological manifestations have been observed. However, only a few cases of Guillain-Barre syndrome (GBS) and COVID-19 have been reported. Therefore, the aim of this study is to investigate a case of concomitant GBS with COVID-19 in Colombia.
Case Presentation:
A 39-year-old woman was admitted to a teaching hospital in Barranquilla, Colombia with a history of progressive general weakness with lower limb dominance. Previous symptoms such as ageusia, anosmia and intense headache were reported. Upon admission, facial diplegia, quadriparesis with lower extremity predominance and Medical Research Council muscular strength of 2/5 in the lower limbs and 4/5 in the upper limbs were reported. During clinical evolution, due to general areflexia, hypertensive emergency and progressive diaphragmatic weakness, the patient was admitted to an intensive care unit. The cerebrospinal fluid analysis showed protein-cytological dissociation and the GBS diagnosis was confirmed via a nerve conduction and electromyography test. With regard to the symptoms before hospitalisation, SARS-CoV-2 diagnostic testing was performed with positive results in the second test. The patient was managed with supportive care and was discharged after 20 days of hospitalization with clinical improvement.
Conclusions:
Only a few cases of COVID-19 with GBS have been reported. Different subtypes have been previously identified, such as Miller-Fisher syndrome and dysautonomic GBS with SARS-CoV-2 infection. This study investigated the first confirmed case of COVID-19 with concomitant GBS in Colombia. In patients with GBS, several viral and bacterial pathogens have been found in case-control studies but the factors that induce the immune-mediated destruction of the nerve tissues have not been determined. Further studies are needed to determine the possible association between COVID-19 exposure and GBS.
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