Selective demyelination of a sciatic nerve allograft after SARS-CoV-2 infection - Case report

Magdalena Koszewicz; Dorota Kaminska; Jacek Martynkiewicz; Adam Domanasiewicz; Jerzy Gosk

doi:10.1016/j.heliyon.2023.e20624

Selective demyelination of a sciatic nerve allograft after SARS-CoV-2 infection - Case report

Heliyon. 2023 Oct 4;9(10):e20624. doi: 10.1016/j.heliyon.2023.e20624. eCollection 2023 Oct.

Authors

Magdalena Koszewicz¹, Dorota Kaminska², Jacek Martynkiewicz³, Adam Domanasiewicz², Jerzy Gosk⁴

Affiliations

¹ Department of Neurology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland.
² Department of Trauma and Orthopedic Surgery, Regional Specialist Hospital, Kamienskiego 73a, 51-124, Wroclaw, Poland.
³ Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland.
⁴ Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wroclaw University of Science and Technology, Grunwaldzki Sq. 13 (D-1), 50-377, Wroclaw, Poland.

Abstract

Peripheral neurological complications are seen after SARS-CoV-2 infections. These are mostly immune-mediated such as Guillaine-Barré syndrome or chronic inflammatory demyelinating polyneuropathy. We present a 39-year-old man treated with a right sciatic nerve allotransplantation with subsequent clinical and electrophysiological improvement within 30 months of observation. After SARS-CoV-2 infection, he developed clinical deterioration with selective sciatic nerve demyelination in a nerve conduction study. Nerve conduction velocity returned to previous values within six months of treatment. Intravenous immunoglobulins were used at standard dosage. The inflammatory immune process seemed to be a cause of peripheral demyelination isolated to a nerve allograft with good reaction for intravenous immunoglobulin treatment.

Keywords: Demyelination; Intravenous immunoglobulins; Nerve allograft; Nerve injury; SARS-CoV-2.

Publication types

Case Reports