A rare case of acute motor axonal neuropathy and myelitis related to SARS-CoV-2 infection
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ORIGINAL COMMUNICATION
A rare case of acute motor axonal neuropathy and myelitis related to SARS‑CoV‑2 infection Fabio Giuseppe Masuccio1 · Massimo Barra2 · Geda Claudio3 · Solaro Claudio1 Received: 7 July 2020 / Revised: 1 September 2020 / Accepted: 3 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract We describe a rare case of post-infective Acute Motor Axonal Neuropathy (AMAN) variant of Guillain-Barrè Syndrome (GBS) associated with myelitis and anti-GD1b positivity after SARS-CoV-2 infection. The patient referred to the hospital reporting a history of ten days lasting moderate fever, myalgia and anosmia, with the onset of progressive quadriparesis and ascending paraesthesias in the four limbs since five days from defervescence. A chest computed tomography demonstrated interstitial pneumonia with “ground glass opacities”, suggesting Coronavirus disease (COVID-19). The patient exhibited three negative reverse-transcription polymerase chain reaction (RT-PCR) nasopharyngeal swabs, while SARS-CoV-2 IgG was found in plasma. The electrophysiological examination demonstrated an AMAN and the spinal cord Magnetic Resonance Imaging (MRI) showed a T2-weighted hyperintense lesion in the posterior part of the spinal cord at the C7-D1 levels. Furthermore, anti-GD1b IgM was detected. GBS and myelitis could exceptionally develop simultaneously. Our findings reasonably support a causality link between COVID-19 and the neurological symptoms, suggesting a post-infective autoimmune reaction. Keywords SARS-CoV-2 · Guillain-barrè syndrome · Myelitis · AMAN · Antiganglioside antibodies
Dear Sirs, The recent pandemy of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) challenged the sanitary systems worldwide, not only for the prominent respiratory features, but also for the neurological complications involving both the central and the peripheral nervous system, the evidence of which is continuously rising [1]. We describe a case of post-infective Acute Motor Axonal Neuropathy (AMAN) variant of Guillain-Barrè Syndrome (GBS) associated with myelitis and anti-GD1b antibodies positivity after SARS-CoV-2 infection. A 70-year-old Caucasian woman affected with obesity and hypertension reported a history of 10 days lasting * Fabio Giuseppe Masuccio [email protected] 1
Department of Neurorehabilitation, C.R.R.F. “Mons. L. Novarese”, Loc. Trompone, SNC, 13040 Moncrivello, VC, Italy
2
Department of Neurology, ASL TO4 Chivasso, C.so G. Ferraris 3, Chivasso, Italy
3
Department of Neurology, ASL TO4 Ivrea, P.za Credenza 2, Ivrea, Italy
moderate fever (with maximum temperature of 38 °C), anosmia and generalized myalgia. After 5 days from defervescence, she experienced progressive difficulties in walking with ascending paraesthesias in the four limbs. Ten days later, she referred to the Chivasso Hospital, Piedmont, Italy, being bedridden. At admission in the emergency department, the patient presented no fever and an oxygen saturation of 96% on room air. The laboratory results revea
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