COVID-19 Sonrası Akut Başlangıçlı Kronik İnflamatuar Demiyelinizan Polinöropati

Abstract

Koronavirüs hastalığı 2019’u (coronavirus disease 2019, COVID-19) takiben Guillain Barre Sendromu (GBS) vakaları bildirilmiştir. Burada farklı yönleri nedeniyle literatüre katkı sağlaması açısından COVID-19 sonrası GBS’den kronik inflamatuar demiyelinizan polinöropatiye (chronic inflammatory demyelinating polyneuropathy, CIDP) evrilen bir olguyu tanımladık. Akut başlayan mikst tipte polinöropati olgusunun beyin omurilik sıvısı incelemesinde albüminositolojik dissosiasyon saptanmadı. Hastaya yükleme dozu ve altı ay boyunca aylık idame intravenöz immünglobulin (IVIG) verildi. Kan ferritin düzeyleri klinik iyileşme ile paralel tedricen azaldı. IVIG tedavisi sonlandırıldıktan 4 ay sonra bulgular tekrarladı, CIDP gelişti ve IVIG tedavisine devam edildi. COVID-19 sonrası GBS hastalarının uzun süreli takibi nüks ve kroniklik açısından önemlidir. Bu olguların klinik takibinde ferritin düzeyi biyokimyasal bir belirteç olabilir.

Keywords

• COVID-19
• GBS
• ferritin
• aksonal
• nüks
• prognoz

Acute Onset Chronic Inflammatory Demyelinating Polyneuropathy Following COVID-19

Abstract

The cases of Guillain Barre Syndrome (GBS) have been reported following the coronavirus disease 2019 (COVID-19). Here, we describe a case that evolved from GBS to chronic inflammatory demyelinating polyneuropathy (CIDP) after COVID-19 in terms of contributing to the literature due to its different aspects. In the cerebrospinal fluid examination of the acute onset mixed type polyneuropathy case, albuminocytological dissociation was not detected. The patient was given a loading dose and monthly maintenance intravenous immunoglobulin (IVIG) for six months. Blood ferritin levels gradually decreased in parallel with clinical improvement. Four months after the IVIG treatment was terminated, the findings recurred and the CIDP was developed and IVIG treatment was continued. Long-term follow-up of post-COVID-19 GBS patients is important in terms of recurrence and chronicity. Ferritin level may be a biochemical marker in the clinical follow-up of these cases.

Keywords

• COVID-19
• GBS
• ferritin
• axonal
• recurrence
• prognosis

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