Guillain-Barré syndrome after COVID-19 in Japan

BMJ Case Rep. 2020 Oct 29;13(10):e239218. doi: 10.1136/bcr-2020-239218.

Abstract

We report the first case of Guillain-Barré syndrome (GBS) associated with SARS-CoV-2 infection in Japan. A 54-year-old woman developed neurological symptoms after SARS-CoV-2 infection. We tested for various antiganglioside antibodies, that had not been investigated in previous cases. The patient was diagnosed with GBS based on neurological and electrophysiological findings; no antiganglioside antibodies were detected. In previous reports, most patients with SARS-CoV-2-infection-related GBS had lower limb predominant symptoms, and antiganglioside antibody tests were negative. Our findings support the notion that non-immune abnormalities such as hyperinflammation following cytokine storms and microvascular disorders due to vascular endothelial damage may lead to neurological symptoms in patients with SARS-CoV-2 infection. Our case further highlights the need for careful diagnosis in suspected cases of GBS associated with SARS-CoV-2 infection.

Keywords: TB and other respiratory infections; immunology; peripheral nerve disease.

Publication types

  • Case Reports
  • Review

MeSH terms

  • COVID-19
  • Coronavirus Infections / complications*
  • Coronavirus Infections / diagnosis*
  • Electromyography / methods
  • Female
  • Guillain-Barre Syndrome / diagnosis*
  • Guillain-Barre Syndrome / etiology*
  • Guillain-Barre Syndrome / therapy
  • Humans
  • Hypesthesia / diagnosis
  • Hypesthesia / etiology
  • Japan
  • Middle Aged
  • Muscle Weakness / diagnosis
  • Muscle Weakness / etiology
  • Pandemics / prevention & control
  • Pandemics / statistics & numerical data
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / diagnosis*
  • Rare Diseases
  • Risk Assessment
  • Severity of Illness Index
  • Treatment Outcome