Guillain-Barre Syndrome Associated with SARS-CoV-2 Infection in a Pediatric Patient
Guillain-Barre Syndrome Associated with SARS-CoV-2 Infection in a Pediatric Patient
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DOI：
10.1093/tropej/fmaa044
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发表时间：
2021-06-01
影响因子：
2
通讯作者：
Guimaraes Lacerda, Marcus Vinicius
中科院分区：
文献类型：
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作者：
Michiles Frank, Carlos Henrique;Vernalha Rocha Almeida, Taynna Prime;Guimaraes Lacerda, Marcus Vinicius
我们报告一个15岁的男性患者的情况下，表现为额部头痛，眶后疼痛，并伴有发热发展到无力和下肢疼痛，并上升到上肢。COVID-19快速检测（IgG和IgM）和鼻咽拭子聚合酶链反应（PCR）对SARS-CoV-2阳性。血液检查、脑脊液分析和脑脊液有氧培养未见异常。脑脊液的PCR检测对最常见的病因和SARS-CoV-2均呈阴性。神经电图研究与格林-巴利综合征的急性运动轴索神经病变相一致。迄今没有涉及年轻患者的病例。因此，这是首例报道的与GBS相关的小儿SARS-CoV-2感染病例。有证据表明，SARS-CoV-2感染并不局限于呼吸道。嗜神经性可以解释COVID-19在儿童中的这一重要神经系统表现。摘要：我们报告一例15岁男性患者，其表现为额部头痛并伴有眼眶后疼痛，伴有发热，并逐渐发展为下肢无力和疼痛，并上升至上肢。新型冠状病毒快速检测和鼻咽分子检测均呈阳性。神经系统检查证实是格林-巴利综合征，这是一种免疫系统攻击神经的疾病，可能由细菌或病毒感染引发。血液检查正常，脑脊液分析对与GBS相关的最常见病毒以及SARS-CoV-2呈阴性。虽然在成人中有描述，但迄今为止没有涉及年轻患者的病例。因此，这是第一例报告的与SARS-CoV-2相关的儿童GBS病例。
We report the case of a 15-year-old male patient presenting frontal headaches with retro-orbital pain accompanied by fever evolving to weakness and pain of the lower limbs, which ascended to upper limbs. A COVID-19 rapid test (IgG and IgM) and nasopharyngeal swab polymerase chain reaction (PCR) was positive for SARS-CoV-2. The blood tests, cerebral spinal fluid (CSF) analysis and CSF aerobic culture revealed no abnormalities. PCR testing of the CSF was negative for the most prevalent etiologies as well as for SARS-CoV-2. Electroneurography study was compatible with the acute motor axonal neuropathy variant of Guillain-Barre syndrome. No cases involving young patients have been presented to date. Therefore, this is the first reported pediatric case of SARS-CoV-2 infection associated with GBS. Evidence reveals that SARS-CoV-2 infection is not limited to the respiratory tract. Neurotropism could explain this important neurologic manifestation of COVID-19 in children.LAY SUMMARYWe report the case of a 15-year-old male patient presenting frontal headaches with retro-orbital pain accompanied by fever evolving to weakness and pain of the lower limbs, which ascended to upper limbs. A COVID-19 rapid test and nasopharyngeal molecular test were positive for the SARS-CoV-2 virus. Neurological examination attested Guillain-Barre syndrome, a condition in which the immune system attacks the nerves and could be triggered by a bacterial or viral infection. The blood tests were normal and cerebral spinal fluid analysis was negative for the most common viruses related to GBS as well as for SARS-CoV-2. Although described in adults, no cases involving young patients have been presented to date. Therefore, this is the first reported case of GBS associated with SARS-CoV-2 in children.