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新冠病毒核酸检测阳性患者的吉兰-巴雷综合征经治疗性血浆置换成功治愈:越南首例病例报告

Guillain-Barré Syndrome in Patient With SARS-CoV-2 PCR Positivity Treated Successfully With Therapeutic Exchange Plasma: A First Case Report From Vietnam.

作者信息

Duong-Quy Sy, Huynh-Truong-Anh Duc, Nguyen-Thi-Kim Thanh, Nguyen-Quang Tien, Nguyen-Chi Thanh, Tran-Xuan Quynh, Nguyen-Nhu Vinh, Ngo Carine, Craig Timothy

机构信息

Department of Clinical Research, Biomedical Research Center, Lam Dong Medical College, Dalat, Vietnam.

Department of Intensive Care Unit, Covid-19 Unit of Phu Chanh, Binh Duong General Hospital, Binh Duong, Vietnam.

出版信息

Front Neurol. 2022 May 25;13:868667. doi: 10.3389/fneur.2022.868667. eCollection 2022.

Abstract

Since the first case of Guillain-Barré syndrome (GBS)-associated SARS-CoV-2 (COVID-19) infection reported in 2020, a series of cases have been published in some countries. In this case report, we present a young patient with GBS, whose clinical and laboratory data were appropriate for the diagnosis of GBS due to COVID-19 infection. Neurological examination revealed the muscular weakness of lower limbs with Medical Research Council (MRC) scale of 2/5 associated with diminished reflexes. Laboratory studies showed the positive nasal swab RT-PCR test for COVID-19, leukopenia, increased ferritin and LDH levels, normal electrolyte and liver and kidney function, and normal chest X-ray. The result of cerebrospinal fluid showed the albuminocytologic dissociation. The patient was treated with remdesivir, dexamethasone, anticoagulation, and therapeutic plasma exchange (TPE). Patient's muscle weakness was significantly improved after 1 week of admission. He was discharged at 23rd days of hospitalization and followed-up in the out-patients department.

摘要

自2020年报告首例与吉兰-巴雷综合征(GBS)相关的严重急性呼吸综合征冠状病毒2(SARS-CoV-2,即新冠病毒)感染病例以来,一些国家已发表了一系列相关病例。在本病例报告中,我们介绍了一名患有GBS的年轻患者,其临床和实验室数据符合新冠病毒感染所致GBS的诊断。神经学检查发现下肢肌肉无力,医学研究委员会(MRC)肌力分级为2/5,伴有反射减弱。实验室检查显示新冠病毒鼻拭子逆转录聚合酶链反应(RT-PCR)检测呈阳性、白细胞减少、铁蛋白和乳酸脱氢酶水平升高、电解质及肝肾功能正常,胸部X线检查正常。脑脊液检查结果显示蛋白细胞分离。该患者接受了瑞德西韦、地塞米松治疗、抗凝治疗及治疗性血浆置换(TPE)。患者入院1周后肌肉无力症状明显改善。他于住院第23天出院,并在门诊进行随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c63/9175001/559c2b13a24a/fneur-13-868667-g0001.jpg

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