Early Guillain-Barré syndrome in coronavirus disease 2019 (COVID-19): a case report from an Italian COVID-hospital

Guillain-Barré syndrome (GBS) is an acute polyradiculoneuropathy associated with dysimmune processes, often related to a previous infectious exposure. During Italian severe acute respiratory syndrome coronavirus-2 outbreak, a woman presented with a rapidly progressive flaccid paralysis with unilater...

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Bibliographic Details
Published in:Neurological sciences 2020-06, Vol.41 (6), p.1351-1354
Main Authors: Ottaviani, Donatella, Boso, Federica, Tranquillini, Enzo, Gapeni, Ilaria, Pedrotti, Giovanni, Cozzio, Susanna, Guarrera, Giovanni M, Giometto, Bruno
Format: Article
Language:English
Subjects:
Aged
Betacoronavirus - isolation & purification
Case reports
Cerebrospinal fluid
Coronaviridae
Coronavirus Infections - blood
Coronavirus Infections - complications
Coronavirus Infections - diagnosis
Coronaviruses
COVID-19
Female
Guillain-Barre syndrome
Guillain-Barre Syndrome - blood
Guillain-Barre Syndrome - diagnosis
Guillain-Barre Syndrome - etiology
Hospitalization
Humans
Inflammation
Italy
Medicine
Medicine & Public Health
Neurology
Neuropathy
Neuroradiology
Neurosciences
Neurosurgery
Pandemics
Paralysis
Pneumonia, Viral - blood
Pneumonia, Viral - complications
Pneumonia, Viral - diagnosis
Psychiatry
SARS-CoV-2
Severe acute respiratory syndrome
Severe acute respiratory syndrome coronavirus 2
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Summary:Guillain-Barré syndrome (GBS) is an acute polyradiculoneuropathy associated with dysimmune processes, often related to a previous infectious exposure. During Italian severe acute respiratory syndrome coronavirus-2 outbreak, a woman presented with a rapidly progressive flaccid paralysis with unilateral facial neuropathy after a few days of mild respiratory symptoms. Coronavirus was detected by nasopharyngeal swab, but there was no evidence of its presence in her cerebrospinal fluid, which confirmed the typical albumin-cytological dissociation of GBS, along with consistent neurophysiological data. Despite immunoglobulin infusions and intensive supportive care, her clinical picture worsened simultaneously both from the respiratory and neurological point of view, as if reflecting different aspects of the same systemic inflammatory response. Similar early complications have already been observed in patients with para-infectious GBS related to Zika virus, but pathological mechanisms have yet to be established.
ISSN:1590-1874
1590-3478
DOI:10.1007/s10072-020-04449-8