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两名儿科患者中与严重急性呼吸综合征冠状病毒2相关的吉兰-巴雷综合征

Guillain-Barré Syndrome Associated with SARS-CoV-2 in Two Pediatric Patients.

作者信息

Al Amrani Fatema, Al-Abdwani Raghad, Al Rashdi Fatma, Al-Ajmi Eiman, Al Futaisi Amna

机构信息

Pediatric Neurology Unit, Department of Child Health, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman.

Pediatric Intensive Care Unit, Department of Child Health, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman.

出版信息

Sultan Qaboos Univ Med J. 2023 Aug;23(3):400-404. doi: 10.18295/squmj.5.2022.040. Epub 2023 Aug 28.

Abstract

Guillain-Barré syndrome (GBS) is a recognised complication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We report two children with GBS associated with SARS-CoV-2 who presented to a tertiary centre in Muscat, Oman in 2021: The first patient was a three-month-old female infant who presented with bradypnea, encephalopathy, and generalised weakness that required mechanical ventilation. Polymerase chain reaction (PCR) testing of the nasopharyngeal swabs (NPS) was positive for SARS-CoV-2. She had axonal variant GBS based on a nerve conduction study, cerebrospinal fluid analysis, and neuroimaging findings. The second patient was a six-year-old girl with fever, vomiting, and diarrhea followed by ascending weakness who presented with quadriplegia and facial weakness. Subsequently, she developed respiratory muscle weakness and required mechanical ventilation. PCR testing of NPS was negative for SARS-Cov-2, however IgG serology analysis was positive. The clinical course of these two patients was rapidly progressive and both of them required mechanical ventilation. The patient with axonal variant GBS made an incomplete recovery.

摘要

吉兰-巴雷综合征(GBS)是严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染的一种公认并发症。我们报告了2021年在阿曼马斯喀特一家三级医疗中心就诊的两名与SARS-CoV-2相关的GBS患儿:首例患者是一名3个月大的女婴,表现为呼吸浅慢、脑病和全身无力,需要机械通气。鼻咽拭子(NPS)的聚合酶链反应(PCR)检测显示SARS-CoV-2呈阳性。根据神经传导研究、脑脊液分析和神经影像学检查结果,她患的是轴索性变异型GBS。第二例患者是一名6岁女孩,先是发热、呕吐和腹泻,随后出现进行性肌无力,表现为四肢瘫和面部无力。随后,她出现呼吸肌无力,需要机械通气。NPS的PCR检测显示SARS-CoV-2呈阴性,但IgG血清学分析呈阳性。这两名患者的临床病程进展迅速,均需要机械通气。轴索性变异型GBS患者恢复不完全。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95cd/10467552/ca5ff4d6857d/squmj2308-400-404f1.jpg

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