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Case Reports
. 2021 Jul 2;67(3):fmaa044.
doi: 10.1093/tropej/fmaa044.

Guillain-Barré Syndrome Associated with SARS-CoV-2 Infection in a Pediatric Patient

Carlos Henrique Michiles Frank  1 , Taynná Vernalha Rocha Almeida  2 , Elyana Almeida Marques  3 , Quezia de Sousa Monteiro  4 , Pablo Vinícius Silveira Feitoza  5   6 , Mayla Gabriela Silva Borba  4   7 , Heline Lira Vasconcelos  1 , Michele de Souza Bastos  1   2 , Marcus Vinicius Guimarães Lacerda  8
Affiliations
Case Reports

Guillain-Barré Syndrome Associated with SARS-CoV-2 Infection in a Pediatric Patient

Carlos Henrique Michiles Frank et al. J Trop Pediatr. .

Abstract

We report the case of a 15-year-old male patient presenting frontal headaches with retro-orbital pain accompanied by fever evolving to weakness and pain of the lower limbs, which ascended to upper limbs. A COVID-19 rapid test (IgG and IgM) and nasopharyngeal swab polymerase chain reaction (PCR) was positive for SARS-CoV-2. The blood tests, cerebral spinal fluid (CSF) analysis and CSF aerobic culture revealed no abnormalities. PCR testing of the CSF was negative for the most prevalent etiologies as well as for SARS-CoV-2. Electroneurography study was compatible with the acute motor axonal neuropathy variant of Guillain-Barré syndrome. No cases involving young patients have been presented to date. Therefore, this is the first reported pediatric case of SARS-CoV-2 infection associated with GBS. Evidence reveals that SARS-CoV-2 infection is not limited to the respiratory tract. Neurotropism could explain this important neurologic manifestation of COVID-19 in children.

Keywords: Guillain–Barré; SARS-CoV-2; adolescent; neuromuscular diseases; pediatrics; syndrome.

Plain language summary

We report the case of a 15-year-old male patient presenting frontal headaches with retro-orbital pain accompanied by fever evolving to weakness and pain of the lower limbs, which ascended to upper limbs. A COVID-19 rapid test and nasopharyngeal molecular test were positive for the SARS-CoV-2 virus. Neurological examination attested Guillain–Barré syndrome, a condition in which the immune system attacks the nerves and could be triggered by a bacterial or viral infection. The blood tests were normal and cerebral spinal fluid analysis was negative for the most common viruses related to GBS as well as for SARS-CoV-2. Although described in adults, no cases involving young patients have been presented to date. Therefore, this is the first reported case of GBS associated with SARS-CoV-2 in children.

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