Hirayama Takehisa, Hongo Yu, Kaida Kenichi, Kano Osamu
Department of Neurology, Toho University Omori Medical Center, Ota-ku, Japan
Division of Neurology, Anti-aging, and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan.
BMJ Case Rep. 2020 Oct 29;13(10):e239218. doi: 10.1136/bcr-2020-239218.
We report the first case of Guillain-Barré syndrome (GBS) associated with SARS-CoV-2 infection in Japan. A 54-year-old woman developed neurological symptoms after SARS-CoV-2 infection. We tested for various antiganglioside antibodies, that had not been investigated in previous cases. The patient was diagnosed with GBS based on neurological and electrophysiological findings; no antiganglioside antibodies were detected. In previous reports, most patients with SARS-CoV-2-infection-related GBS had lower limb predominant symptoms, and antiganglioside antibody tests were negative. Our findings support the notion that non-immune abnormalities such as hyperinflammation following cytokine storms and microvascular disorders due to vascular endothelial damage may lead to neurological symptoms in patients with SARS-CoV-2 infection. Our case further highlights the need for careful diagnosis in suspected cases of GBS associated with SARS-CoV-2 infection.
我们报告了日本首例与严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染相关的吉兰-巴雷综合征(GBS)病例。一名54岁女性在感染SARS-CoV-2后出现神经症状。我们检测了各种抗神经节苷脂抗体,这些抗体在之前的病例中未被研究过。根据神经学和电生理学检查结果,该患者被诊断为GBS;未检测到抗神经节苷脂抗体。在之前的报告中,大多数与SARS-CoV-2感染相关的GBS患者以下肢症状为主,抗神经节苷脂抗体检测为阴性。我们的研究结果支持这样一种观点,即细胞因子风暴后的过度炎症和血管内皮损伤导致的微血管疾病等非免疫异常可能导致SARS-CoV-2感染患者出现神经症状。我们的病例进一步凸显了对疑似与SARS-CoV-2感染相关的GBS病例进行仔细诊断的必要性。