Longitudinally extensive transverse myelitis as a sign of multisystem inflammatory syndrome following COVID-19 infection: A pediatric case report

J Neuroimmunol. 2021 Nov 15:360:577704. doi: 10.1016/j.jneuroim.2021.577704. Epub 2021 Aug 28.

Abstract

COVID-19 infection can cause inflammatory reactions that could involve several organs. In the pediatric population, Multi-System Inflammatory Syndrome in Children (MIS-C) has been reported as one of the consequences of COVID-19. We report a unique pediatric COVID-19 patient with MIS-C, associated with paralysis of the extremities. MRI showed abnormal signal in the cervical spinal cord compatible with transverse myelitis. Methylprednisolone and IVIG were administered, without significant symptom improvement. As a next step, Infliximab was tried for her, and she responded remarkably well to this treatment. Infliximab may be considered as a treatment option in COVID-19 patients with transverse myelitis.

Keywords: COVID-19; Immunotherapy; Infliximab; Multi-System Inflammatory Syndrome; Pediatric; Transverse myelitis.

Publication types

  • Case Reports

MeSH terms

  • Antirheumatic Agents / therapeutic use
  • COVID-19 / complications*
  • COVID-19 / diagnostic imaging
  • COVID-19 / etiology
  • COVID-19 Drug Treatment
  • Child
  • Female
  • Humans
  • Infliximab / therapeutic use
  • Myelitis, Transverse / diagnostic imaging*
  • Myelitis, Transverse / drug therapy
  • Myelitis, Transverse / etiology*
  • Systemic Inflammatory Response Syndrome / diagnostic imaging*
  • Systemic Inflammatory Response Syndrome / drug therapy
  • Systemic Inflammatory Response Syndrome / etiology*

Substances

  • Antirheumatic Agents
  • Infliximab

Supplementary concepts

  • pediatric multisystem inflammatory disease, COVID-19 related