Postinfectious Onset of Myasthenia Gravis in a COVID-19 Patient.
Postinfectious Onset of Myasthenia Gravis in a COVID-19 Patient.
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DOI：
10.3389/fneur.2020.576153
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发表时间：
2020
影响因子：
3.4
通讯作者：
Wegner F
中科院分区：
文献类型：
--
作者：
Huber M;Rogozinski S;Puppe W;Framme C;Höglinger G;Hufendiek K;Wegner F
目的：我们报告一例年轻女性在COVID-19后感染后发生重症肌无力，在入院前1个月出现轻度呼吸道症状和嗅觉丧失/味觉丧失。方法：患者数据来自德国汉诺威医学院的病历。获得患者的书面知情同意书。结果如下：一位21岁的女性病患，因右侧部分性眼球麻痹及上睑下垂而引起亚急性垂直移位复视。约4周前，患者出现轻度呼吸道症状，四肢和头部疼痛，无发热，伴有嗅觉丧失/味觉丧失。在后一种症状持续约10天期间，患者已经注意到“眼睛疲劳”和波动的复视。临床评估，包括阳性试验与依地芬氯铵和增加乙酰胆碱受体抗体相关的眼部表现的病因重症肌无力。使用三种不同的血清学试验（Abbott，DiaSorin，Euroimmun）在血清中检测到针对SARS-CoV-2的抗体（伊加/IgG），表明这种特定的冠状病毒是我们患者先前的传染源。通过静脉注射免疫球蛋白和口服吡啶斯的明成功地治疗了肌无力综合征。结论：这是第一例以感染后重症肌无力为神经系统并发症的COVID-19患者。
Objective: We report the case of a young woman with postinfectious onset of myasthenia gravis after COVID-19 with mild respiratory symptoms and anosmia/ageusia 1 month before admission to our neurological department. Methods: Patient data were derived from medical records of Hannover Medical School, Germany. Written informed consent was obtained from the patient. Results: The 21-year-old female patient presented with subacute, vertically shifted double vision evoked by right sided partial oculomotor paresis and ptosis. About 4 weeks earlier she had suffered from mild respiratory symptoms, aching limbs and head without fever, accompanied by anosmia/ageusia. During the persistence of the latter symptoms for around 10 days the patient had already noticed “tired eyes” and fluctuating double vision. Clinical assessment including a positive test with edrophonium chloride and increased acetylcholine receptor antibodies related the ocular manifestation etiologically to myasthenia gravis. Antibodies (IgA/IgG) against SARS-CoV-2 using three different serological tests (Abbott, DiaSorin, Euroimmun) were detected in serum suggesting this specific coronavirus as previously infectious agent in our patient. The myasthenic syndrome was treated successfully with intravenous immunoglobulins and oral pyridostigmine. Conclusion: This is the first case presentation of postinfectious myasthenia gravis as neurological complication in a COVID-19 patient.
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影响因子：
2.6
作者：
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通讯作者：
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通讯作者：
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作者：
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通讯作者：
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