Acute inflammatory demyelinating polyneuritis in association with an asymptomatic infection by SARS-CoV-2
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LETTER TO THE EDITORS
Acute inflammatory demyelinating polyneuritis in association with an asymptomatic infection by SARS‑CoV‑2 Martina Bracaglia1 · Ilaria Naldi1 · Alessandra Govoni2 · Donatella Brillanti Ventura3 · Patrizia De Massis1 Received: 24 May 2020 / Revised: 14 June 2020 / Accepted: 18 June 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Dear Sirs, After the recognition of COVID-19 disease, caused by the SARS-CoV-2, several reports refer to neurological symptoms in such patients [1, 2], including Guillain–Barré Syndrome (GBS) [3–9] We describe a case of acute demyelinating polyneuritis in association with asymptomatic SARS-CoV-2 infection. A 66-years old Maroccan woman, the resident in the Bologna area, was admitted to Imola Hospital on March 15th, 2020, for hyposthenia in all limbs, severe in lower, with a Medical Research Council (MRC) scale of 1/5 in distal and 2/5 in proximal of the lower extremities and 3/5 in distal and 4/5 in proximal of the upper extremities, with a distal tingling sensation and pronounced lumbar pain for about eight days. She was unable to walk, reported difficulty in swallowing and speeching, tendon reflexes were abolished. Vital signs were normal, medical history was negative and no infection was reported in the previous month. We hypothesized GBS and performed nerve conduction studies consistent with demyelinating polyneuropathy (Tables 1, 2) and cerebrospinal fluid (CSF) analysis, consistent with our hypothesis (protein content 245 mg/dL, cells 13/mmc, polymorphonucleate 61.5%). Microbiologic testing on CSF and serum was negative (HSV1-2, EBV, VZV, CMV, HIV, Mycoplasma Pneumoniae, Borrelia). Anti-ganglioside antibodies were negative. We Martina Bracaglia, Ilaria Naldi and Patrizia De Massis contributed equally. * Martina Bracaglia [email protected] 1
Neurology Unit, Medical Oncological Department, S. Maria Della Scaletta Hospital, 40026 Imola, BO, Italy
2
Internal Medicine, Medical Oncological Department, S. Maria Della Scaletta Hospital, 40026 Imola, BO, Italy
3
Montecatone Rehabilitation Institute, 40026 Imola, BO, Italy
excluded electrolytic abnormalities, heavy metal or drugs toxicity, endocrinological disorders, folate and vitamin B12 deficiency. Blood analysis showed elevated CPK (461 U/L, normal
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