Concurrent Guillain-Barre/acute transverse myelitis overlap syndrome after COVID-19 infection in a patient with ITP: A case report

Medicine (Baltimore). 2024 Nov 8;103(45):e40346. doi: 10.1097/MD.0000000000040346.

Abstract

Rationale: Patients with chronic immune diseases, such as idiopathic thrombocytopenic purpura (ITP), should be alert for Guillain-Barre/acute transverse myelitis (GBS/ATM) overlap syndrome after infection with coronavirus disease 2019 (COVID-19).

Patient concerns: A 65-year-old male with an ITP history, who presented with limb numbness and weakness, urinary retention, right peripheral facial paralysis, and diplopia 2 weeks after being diagnosed with COVID-19.

Diagnosis: GBS/ATM overlap syndrome secondary to COVID-19.

Interventions: Five days intravenous immune globulin, methylprednisolone (500 mg) was added for treatment. He was discharged with medicine and continued to take Methylprednisolone tablets (60 mg/d), Eltrombopag olamine (25 mg 1/d), Mecobalamine tablets, vitamin B1, and rehabilitation treatment outside the hospital.

Outcomes: The patient significantly improved after initial treatment, he returned to normal life after 8 weeks. Five months later, he was infected with COVID-19 for the second time, exhibiting only symptoms of upper respiratory tract infection and no other discomfort.

Lessons: COVID-19 infection can lead to secondary myelitis and GBS, and GBS/ATM overlap syndrome is rare, but patients are significantly better after immunization and hormone therapy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • COVID-19* / complications
  • Guillain-Barre Syndrome* / diagnosis
  • Guillain-Barre Syndrome* / etiology
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Male
  • Methylprednisolone / administration & dosage
  • Methylprednisolone / therapeutic use
  • Myelitis, Transverse* / diagnosis
  • Myelitis, Transverse* / drug therapy
  • Myelitis, Transverse* / etiology
  • Myelitis, Transverse* / virology
  • Purpura, Thrombocytopenic, Idiopathic* / complications
  • Purpura, Thrombocytopenic, Idiopathic* / diagnosis
  • Purpura, Thrombocytopenic, Idiopathic* / drug therapy
  • SARS-CoV-2*

Substances

  • Methylprednisolone
  • Immunoglobulins, Intravenous