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吉兰-巴雷综合征与新型冠状病毒肺炎的关联:一例病例报告及文献综述

Association of Guillain-Barre Syndrome With COVID-19: A Case Report and Literature Review.

作者信息

Singh Romil, Shiza Saher T, Saadat Rabeea, Dawe Manal, Rehman Usama

机构信息

Critical Care, Mayo Clinic, Rochester, USA.

Internal Medicine, Deccan College of Medical Sciences, Hyderabad, IND.

出版信息

Cureus. 2021 Mar 11;13(3):e13828. doi: 10.7759/cureus.13828.

Abstract

There is growing evidence of neurological involvement in patients with coronavirus disease 19 (COVID-19), suggesting that Guillain-Barre syndrome (GBS) can also occur with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a neurological complication. Herein, we describe a unique case of a 45-year-old male who manifested with sudden onset progressive symmetric ascending paralysis leading to quadriplegia one week after developing fever, cough, and dyspnea. On examination, he had areflexia in lower limbs and hyporeflexia in upper limbs. Hypoesthesia to fine touch and vibration distal to calf was noted. His reverse transcriptase-polymerase chain reaction (RT-PCR) was positive for COVID-19, and his cerebrospinal fluid (CSF) analysis revealed albumin-cytologic dissociation. The diagnosis of GBS was made based on clinical presentation and neurophysiological studies due to COVID-19. He was commenced on intravenous immunoglobulin, and improvement in his condition was observed. He was discharged to a rehabilitation center for regular physical therapy.

摘要

越来越多的证据表明,新型冠状病毒肺炎(COVID-19)患者存在神经受累情况,这表明吉兰-巴雷综合征(GBS)也可能作为一种神经并发症,与严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染同时发生。在此,我们描述了一例独特的病例,一名45岁男性,在出现发热、咳嗽和呼吸困难一周后,突然出现进行性对称性上行性麻痹,最终导致四肢瘫痪。检查发现,他下肢无反射,上肢反射减弱。小腿远端对精细触觉和振动感觉减退。他的新型冠状病毒逆转录聚合酶链反应(RT-PCR)检测呈COVID-19阳性,脑脊液(CSF)分析显示蛋白细胞分离。基于COVID-19的临床表现和神经生理学研究,诊断为GBS。开始给他静脉注射免疫球蛋白后,观察到他的病情有所改善。他出院后前往康复中心接受定期物理治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ed6/8035985/914acb42a19e/cureus-0013-00000013828-i01.jpg

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