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Endocrine, Metabolic & Immune Disorders - Drug Targets

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ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

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Case Report

A Case of Intractable Hypophosphatemia in a Patient with Guillain-Barré Syndrome and Encephalitis after SARS-CoV-2 Infection

Author(s): Yawen Zheng, Yuanyuan Hou, Mingzhu Qi, Yongxiang Zhang, Chao Han, Hui Sun and Jiang Li*

Volume 24, Issue 11, 2024

Published on: 16 January, 2024

Page: [1346 - 1350] Pages: 5

DOI: 10.2174/0118715303261924231117055702

Price: $65

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Abstract

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection attacks the respiratory and nervous systems. Among patients with SARS-CoV-2 infection, cases with simultaneous central and peripheral nervous system damage are rare, and those with intractable hypophosphatemia and hypokalemia complicating the former have not been reported yet.

Case Presentation: A 59-year-old woman presented to the emergency department with incoherent speech evolving for 3 days. She had tested positive for the SARS-CoV-2 RT-PCR assay 8 days earlier. Her physical examination showed progressive limb weakness with diminished tendon reflexes and normal sensory examination. Cranial MRI revealed multiple abnormal signals in the brain. Cerebrospinal fluid (CSF) analysis and electromyography revealed acute motor axonal neuropathy (AMAN), further diagnosed as encephalitis combined with GuillainBarré syndrome (GBS). The patient received glucocorticoid therapy, intravenous immune globulin (IVIG), and rehabilitation therapy. The patient experienced an intractable hypophosphatemia and hypokalemia during the treatment period, which was not effectively corrected several times. The symptoms improved after 1 month of treatment.

Conclusion: Early diagnosis is important for the management of Guillain-Barré syndrome associated with SARS-CoV-2 infection. Moreover, in order to prevent life-threatening long-term persistent electrolyte disturbances in non-seriously ill patients, clinicians should pay particular attention to their electrolyte status.

Keywords: COVID-19, SARS-CoV-2, Guillain-Barré Syndrome, hypophosphatemia, electrolyte disturbances, encephalitis.

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