1887
  1. Home
  2. A-Z Publications
  3. Qatar Medical Journal
  4. Volume 2024, Issue 1
  5. Article
Volume 2024, Issue 1
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Background: Previous studies have delineated different neurological manifestations associated with coronavirus disease 2019 (COVID-19). Myelitis is identified as a rare neurological complication resulting from a COVID-19 infection. Limited information is available regarding the treatment of patients experiencing this condition.

Case report: This report extracts data from the medical record of a post-COVID-19 myelitis patient at Buriram Hospital and follows up prospectively on the patient’s symptoms after treatment.

A 61-year-old man, previously vaccinated for COVID-19 and with a history of hypertension and dyslipidemia, experienced progressive bilateral lower-extremity weakness (recorded as muscle strength grade 2/5 in both lower extremities) for 6 weeks. He had a mild case of COVID-19 2 months earlier, which resolved in 10 days without specific treatment. However, 2 weeks after being diagnosed with COVID-19, he developed weakness in his lower limbs, numbness below the nipple, and urinary retention. Spinal magnetic resonance imaging revealed multifocal longitudinal myelitis. Despite initial treatment with methylprednisolone, the patient showed no clinical improvement. Consequently, he underwent five cycles of plasmapheresis. Three months after discharge, a notable improvement was observed, with his muscle strength graded at 4/5 in both lower extremities and the resolution of sensory and urinary symptoms.

Conclusions: We presented the case of a COVID-19-vaccinated patient, in whom COVID-19 infection might have led to myelitis. We found promising results in treating prolonged COVID-19-related myelitis symptoms through the use of plasmapheresis.

© 2024 Mitarnun, Kongngern, Tantisungvarakoon, Boonsayomphu, Tianchetsada, Potchanapong, Licensee HBKU Press.
Loading

Article metrics loading...

/content/journals/10.5339/qmj.2024.19
2024-03-14
2024-05-16
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2024/1/qmj.2024.19.html?itemId=/content/journals/10.5339/qmj.2024.19&mimeType=html&fmt=ahah

References

  1. Mitarnun W, Apiwattanakul M, Thodthasri T, Tantisungvarakoon P, Pangwong W. Steroid administration for post-COVID-19 Parkinsonism: a case report. Neurol Clin Neurosci. 2023; 11:(1):49–51. doi: 10.1111/ncn3.12679
     [Google Scholar]
  2. Mitarnun W, Naksanguan T, Laoharattanahirun N, Roekrat P, Kimavaha S, Kajornrith W. Myelin-oligodendrocyte glycoprotein antibody-associated optic neuritis following SARS-CoV-2 pneumonia: a case report. Neurol Clin Neurosci. 2022; 10:(3):181–2. doi: 10.1111/ncn3.12595
     [Google Scholar]
  3. Sarioglu E, Yilmaz Sarialtin S, Çoban T. Neurological complications and potential effects of COVID-19: symptoms and conceivable mechanisms. Brain Hemorrhages. 2023. doi: 10.1016/j.hest.2023.02.001 [Epub ahead of print].
     [Google Scholar]
  4. Abdelhady M, Elsotouhy A, Vattoth S. Acute flaccid myelitis in COVID-19. BJR Case Rep. 2020; 6:(3):20200098. doi: 10.1259/bjrcr.20200098
     [Google Scholar]
  5. Schulte EC, Hauer L, Kunz AB, Sellner J. Systematic review of cases of acute myelitis in individuals with COVID-19. Eur J Neurol. 2021; 28:(10):3230–44. doi: 10.1111/ene.14952
     [Google Scholar]
  6. Ellul MA, Benjamin L, Singh B, Lant S, Michael BD, Easton A, et al. Neurological associations of COVID-19. Lancet Neurol. 2020; 19:(9):767–83. doi: 10.1016/S1474-4422(20)30221-0
     [Google Scholar]
  7. Baghbanian SM, Namazi F. Post COVID-19 longitudinally extensive transverse myelitis (LETM)-a case report. Acta Neurol Belg. 2021; 121:(6):1875–6. doi: 10.1007/s13760-020-01497-x
     [Google Scholar]
  8. Kaur H, Mason JA, Bajracharya M, McGee J, Gunderson MD, Hart BL, et al. Transverse myelitis in a child with COVID-19. Pediatr Neurol. 2020; 112:5–6. doi: 10.1016/j.pediatrneurol.2020.07.017
     [Google Scholar]
  9. Bhat A, Naguwa S, Cheema G, Gershwin ME. The epidemiology of transverse myelitis. Autoimmun Rev. 2010; 9:(5):A395–9. doi: 10.1016/j.autrev.2009.12.007
     [Google Scholar]
  10. Frohman EM, Wingerchuk DM. Clinical practice. Transverse myelitis. N Engl J Med. 2010; 363:(6):564–72. doi: 10.1056/NEJMcp1001112
     [Google Scholar]
  11. Jeffery DR, Mandler RN, Davis LE. Transverse myelitis. Retrospective analysis of 33 cases, with differentiation of cases associated with multiple sclerosis and parainfectious events. Arch Neurol. 1993; 50:(5):532–5. doi: 10.1001/archneur.1993.00540050074019
     [Google Scholar]
  12. Fiani B, Covarrubias C, Jarrah R. Neuroimmunology and novel methods of treatment for acute transverse myelitis. Cureus. 2021; 13:(8):e17043. doi: 10.7759/cureus.17043
     [Google Scholar]
  13. Lopez Chiriboga S, Flanagan EP. Myelitis and other autoimmune myelopathies. Continuum. 2021; 27:(1):62–92. doi: 10.1212/CON.0000000000000900
     [Google Scholar]
  14. Falsey AR, Sobieszczyk ME, Hirsch I, Sproule S, Robb ML, Corey L, et al. Phase 3 safety and efficacy of AZD1222 (ChAdOx1 nCoV-19) COVID-19 vaccine. N Engl J Med. 2021; 385:(25):2348–60. doi: 10.1056/NEJMoa2105290
     [Google Scholar]
  15. Nemoto W, Yamagata R, Nakagawasai O, Nakagawa K, Hung WY, Fujita M, et al. Effect of spinal angiotensin-converting enzyme 2 activation on the formalin-induced nociceptive response in mice. Eur J Pharmacol. 2020; 872:172950. doi: 10.1016/j.ejphar.2020.172950
     [Google Scholar]
  16. Kansagra SM, Gallentine WB. Cytokine storm of acute necrotizing encephalopathy. Pediatr Neurol. 2011; 45:(6):400–2. doi: 10.1016/j.pediatrneurol.2011.09.007
     [Google Scholar]
  17. Mohammadi S, Moosaie F, Aarabi MH. Understanding the immunologic characteristics of neurologic manifestations of SARS-CoV-2 and potential immunological mechanisms. Mol Neurobiol. 2020; 57:(12):5263–75. doi: 10.1007/s12035-020-02094-y
     [Google Scholar]
  18. Lisnic V, Nemtan V, Hacina E, Topciu G, Manole E, Thurnher MM, et al. Acute transverse myelitis in a HIV-positive patient with COVID-19. Res Square. [Preprint]. 2020. doi: 10.21203/rs.3.rs-50901/v1
     [Google Scholar]
  19. Valiuddin H, Skwirsk B, Paz-Arabo P. Acute transverse myelitis associated with SARS-CoV-2: a case-report. Brain Behav Immun Health. 2020; 5:100091. doi: 10.1016/j.bbih.2020.100091
     [Google Scholar]
  20. Masuccio FG, Barra M, Claudio G, Claudio S. A rare case of acute motor axonal neuropathy and myelitis related to SARS-CoV-2 infection. J Neurol. 2021; 268:(7):2327–30. doi: 10.1007/s00415-020-10219-5
     [Google Scholar]
  21. Rifino N, Censori B, Agazzi E, Alimonti D, Bonito V, Camera G, et al. Neurologic manifestations in 1760 COVID-19 patients admitted to Papa Giovanni XXIII Hospital, Bergamo, Italy. J Neurol. 2021; 268:(7):2331–8. doi: 10.1007/s00415-020-10251-5
     [Google Scholar]
  22. Sarma D, Bilello LA. A case report of acute transverse myelitis following novel coronavirus infection. Clin Pract Cases Emerg Med. 2020; 4:(3):321–3. doi: 10.5811/cpcem.2020.5.47937
     [Google Scholar]
  23. Sotoca J, Rodríguez-Álvarez Y. COVID-19-associated acute necrotizing myelitis. Neurol Neuroimmunol Neuroinflamm. 2020; 7:(5):e803. doi: 10.1212/NXI.0000000000000803
     [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/qmj.2024.19
Loading
Plasmapheresis in post-COVID-19 myelitis: A case report
Qatar Medical Journal 2024, 19 (2024); https://doi.org/10.5339/qmj.2024.19
/content/journals/10.5339/qmj.2024.19
/content/journals/10.5339/qmj.2024.19
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): COVID-19, myelitis, plasmapheresis, severe acute respiratory syndrome coronavirus 2 and steroids

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error