COVID-19 infection presented as Guillain-Barre Syndrome: Report of two new cases and review of 116 reported cases and case series.

BACKGROUND: /Aims: Corona virus disease 2019 (COVID 19) is a pandemic infectious disease of 2020, which often presents with respiratory and gastrointestinal symptoms. The behavior of the virus and its full clinical picture has not been fully studied yet. Many case reports and case series have been running in order to elaborate different presentations and associations. Pulmonary and gastrointestinal features of COVID-19 infection are well outlined; however, neurological manifestations are less defined. CASE PRESENTATION: We report two adult cases of COVID-19 infection presented with acute Guillain-Barre Syndrome (GBS), and a literature review on the causal association between COVID-19 and GBS. CONCLUSION: Our two case reports in addition to literature review of 116 published cases may help offer insight into the clinical course of COVID-19 infection. Our two COVID-19 patients presented with neurological manifestations of GBS which were not preceded with any respiratory, gastrointestinal or other systemic infection. This leads us to raise the possibility of establish direct causal association between COVID-19 infection and GBS. Physicians should have high clinical suspicions when encounter GBS patient during the current COVID-19 pandemic and consider co-existence of COVID-19 infection that may warrant SARS-CoV-2 testing, isolation precautions, and specific treatment for Covid-19 infection.

Eltrombopag and its beneficial role in management of ulcerative Colitis associated with ITP as an upfront therapy case report.

Eltrombopag can be used safely as upfront medication in the management of ulcerative colitis as well as ITP, and it showed a beneficial effect in both disorders.

Low-Dose Eltrombopag in a Patient with Chronic Idiopathic Thrombocytopenic Purpura Post Sleeve Gastrectomy.

Idiopathic thrombocytopenic purpura (ITP) is a disease in which the immune system attacks platelets and causes decrease in its number exposing the patient to risk of bleeding. It is diagnosed by exclusion. Eltrombopag is a thrombopoietin receptor agonist which is used as second-line treatment for patients with ITP. The usual starting dose is 25 mg daily and maintenance dose is 75 mg daily. Little is known about the dose of eltrombopag in patients with sleeve gastrectomy since reduction in the amount of functioning gastrointestinal tract after gastric bypass surgery leads to decreased time to drug absorption and reduced drug bioavailability. Here we are reporting a 46-year-old female with ITP and sleeve gastrectomy who responded to low-dose eltrombopag 25 mg every other day, which is equivalent to 12.5 mg daily, and maintained adequate platelet counts on this dose.