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J Neurovirol ; 27(5): 797-801, 2021 10.
Article in English | MEDLINE | ID: covidwho-1432669


Guillain-Barré syndrome (GBS) is an ascending demyelinating polyneuropathy often associated with recent infection. Miller Fisher syndrome represents a variant with predominant facial and cranial nerve involvement, although Miller Fisher and Guillain-Barré overlap syndromes can occur. Guillain-Barré spectrum syndromes have been thought to be rare among solid organ transplant recipients. We describe an immunocompromised patient with a liver transplant who presented with ophthalmoplegia and bulbar deficits. His symptoms rapidly progressed to a state of descending paralysis involving the diaphragm; he then developed acute respiratory failure and eventually developed quadriparesis. Electromyography and a nerve conduction study demonstrated a severe sensorimotor axonal polyneuropathy consistent with Miller Fisher variant Guillain-Barré syndrome. Despite several negative nasopharyngeal swabs for COVID-19 polymerase chain reaction, a serology for SARS-CoV-2 IgG was positive. He was diagnosed with Miller Fisher-Guillain-Barré overlap syndrome with rapid recovery following treatment with plasma exchange. Although Guillain-Barré is a rare complication in solid organ transplant recipients, this case highlights the importance of rapid diagnosis and treatment of neurologic complications in transplant patients. Furthermore, it demonstrates a possible case of neurological complications from COVID-19 infection.

COVID-19/complications , Guillain-Barre Syndrome/immunology , Guillain-Barre Syndrome/virology , Miller Fisher Syndrome/immunology , Miller Fisher Syndrome/virology , Guillain-Barre Syndrome/therapy , Humans , Immunocompromised Host , Liver Transplantation , Male , Middle Aged , Miller Fisher Syndrome/therapy , Plasmapheresis , SARS-CoV-2 , Transplant Recipients