Covid-19 systemic infection exacerbates pre-existing acute disseminated encephalomyelitis (ADEM).
J Neuroimmunol
; 349: 577405, 2020 12 15.
Article
in English
| MEDLINE | ID: covidwho-796110
ABSTRACT
Acute disseminated encephalomyelitis (ADEM) is an uncommon diagnosis in adults. It is known to be due to an abnormal immune response to a systemic infection rather than direct viral invasion to the central nervous system. There have been few reports of ADEM diagnosed in the setting of COVID-19 systemic infection. However, we report a case of Coxsackie induced ADEM that remitted but got exacerbated by COVID-19 infection. The patient contracted the COVID-19 infection shortly after being discharged to a rehabilitation facility. Direct COVID-19 neuroinvasion was ruled out via CSF PCR testing for the virus. The patient responded well to pulse steroid therapy and plasmapheresis in both occasions. We hypothesize that COVID-19 infection can flare-up a recently remitted ADEM via altering the immune responses. It is known now that COVID-19 infection can produce cytokine storming. Cytokine pathway activation is known to be involved in the pathology of ADEM. Caution regarding discharging immune suppressed patient to the inpatient rehabilitation facility should be made in the era of COVID-19 pandemic.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Coxsackievirus Infections
/
Encephalomyelitis, Acute Disseminated
/
Symptom Flare Up
/
COVID-19
Type of study:
Case report
Topics:
Long Covid
/
Vaccines
Limits:
Female
/
Humans
/
Middle aged
Language:
English
Journal:
J Neuroimmunol
Year:
2020
Document Type:
Article
Similar
MEDLINE
...
LILACS
LIS