COVID-19–associated Acute Disseminated Encephalomyelitis–like Disease in 2 Children
| Autor: | Ayşe İrem Sofuoğlu, Gonca Bektaş, Mustafa Oğur, Nihal Akçay, Mehmet Emin Menentoğlu, Esra Şevketoğlu, Figen Palabıyık |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Microbiology (medical) Pathology medicine.medical_specialty TPE Encephalopathy Young Adult Cerebrospinal fluid medicine Humans medicine.diagnostic_test SARS-CoV-2 business.industry Encephalomyelitis Acute Disseminated Respiratory disease COVID-19 Disease Management Immunoglobulins Intravenous Electroencephalography Magnetic resonance imaging ADEM-like disease encephalopathy medicine.disease Magnetic Resonance Imaging Hyperintensity Treatment Outcome Infectious Diseases Methylprednisolone Pediatrics Perinatology and Child Health Acute disseminated encephalomyelitis Brief Reports Female Disease Susceptibility Symptom Assessment Complication business Biomarkers medicine.drug |
| Zdroj: | The Pediatric Infectious Disease Journal |
| ISSN: | 0891-3668 |
| Popis: | Background The coronavirus disease 2019 pandemic was caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although the predominant clinical presentation is a respiratory disease, neurological manifestations are being recognized increasingly. Case report We report 2 children aged 9 years old who developed acute disseminated encephalomyelitis-like disease associated with SARS-CoV-2. Seizures and encephalopathy were the main central nervous system symptoms. The cerebrospinal fluid analysis performed within the first week of disease onset showed elevated protein in both children with normal cell count and no evidence of infection including negative SARS-CoV-2 by antibody and polymerase chain reaction. Brain magnetic resonance imaging revealed T2A, fluid-attenuated inversion recovery cortical and subcortical hyperintensity without restricted diffusion consistent with acute disseminated encephalomyelitis-like disease. They received methylprednisolone followed by therapeutic plasma exchange. One of them showed complete clinical improvement and resolution in magnetic resonance imaging findings. The other developed laminar necrosis in brain magnetic resonance imaging and showed significant clinical improvement after therapeutic plasma exchange. He was positive for positive SARS-CoV-2 antibody in cerebrospinal fluid on day 55 of admission. They were both positive for SARS-CoV-2 antibodies in serum after 2 weeks. Conclusions Our two cases highlight the occurrence of acute disseminated encephalomyelitis-like disease as a postinfectious/immune-mediated complication of SARS-CoV-2 infection. |
| Databáze: | OpenAIRE |
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