High-dose intravenous immunoglobulins as a therapeutic option in critical illness polyneuropathy accompanying SARS-CoV-2 infection: A case-based review of the literature (Review)
| Autor: | Rodica Bălașa, Roxana Adriana Cioflinc, Anca Moțățăianu, Smaranda Maier, Bianca Liana Grigorescu, Laura Bărcuțean, Adina Stoian, Mircea Stoian, Zoltan Bajko |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Cancer Research
medicine.medical_specialty critical illness polyneuropathy Critical Illness Myopathy Review intravenous immunoglobulins medicine.disease_cause law.invention neurological complications Immunology and Microbiology (miscellaneous) law medicine Critical illness polyneuropathy Intensive care medicine business.industry SARS-CoV-2 infection COVID-19 General Medicine Immune dysregulation medicine.disease Intensive care unit Systemic inflammatory response syndrome Neurologic manifestation Complication business Cytokine storm |
| Zdroj: | Experimental and Therapeutic Medicine |
| ISSN: | 1792-1015 1792-0981 |
| Popis: | The still ongoing COVID-19 pandemic has exposed the medical community to a number of major challenges. A significant number of patients require admission to intensive care unit (ICU) services due to severe respiratory, thrombotic and septic complications and require long-term hospitalization. Neuromuscular weakness is a common complication in critically ill patients who are treated in ICUs and are mechanically ventilated. This complication is frequently caused by critical illness myopathy (CIM) or critical illness polyneuropathy (CIP) and leads to difficulty in weaning from the ventilator. It is thought to represent an important neurologic manifestation of the systemic inflammatory response syndrome (SIRS). COVID-19 infection is known to trigger strong immune dysregulation, with an intense cytokine storm, as a result, the frequency of CIP is expected to be higher in this setting. The mainstay in the diagnosis of this entity beside the high level of clinical awareness is the electrophysiological examination that provides evidence of axonal motor and sensory polyneuropathy. The present article presents the case of a 54-year-old woman with severe COVID 19 infection who developed neuromuscular weakness, which turned out to be secondary to CIP and was treated successfully with a high dose of human intravenous immunoglobulins. Related to this case, we reviewed the relevant literature data regarding the epidemiology, pathophysiology and clinical features of this important complication and discussed also the treatment options and prognosis. |
| Databáze: | OpenAIRE |
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