DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20220533

Post COVID-19 Guillain Barre syndrome with syndrome of inappropriate secretion of antidiuretic hormone

Adarsha Gopadi Krishna Bhat, Manjunatha Handattu Hande, Nithin K. Bhat, Sriram Bhat

Abstract


Guillain Barre syndrome (GBS) is a rare but potentially fatal immune mediated disorder of peripheral nerves and nerve roots usually triggered by infections characterized by ascending paralysis with or without sensory symptoms, hyporeflexia to areflexia. Usually preceded by gastrointestinal or respiratory infection. Post COVID-19 neurological manifestation include GBS, transverse myelitis etc., occur at varying incidence rates at various places. Here we report a 42-year-old lady who had COVID-19 recovered presented with quadriparesis with absent deep tendon reflexes with electro-diagnostically proven AMSAN variety of GBS treated successfully with IVIg. Patient was having hyponatremia which was diagnosed to be due to SIADH and was successfully treated with fluid restriction and tolvaptan. This case is being reported due to combination of COVID-19, COVID vaccination shortly before GBS and hyponatremia due to syndrome of inappropriate secretion of antidiuretic hormone (SIADH) which is quite rare combination.


Keywords


COVID-19, SIADH, hyponatremia, vaccine, Acute inflammatory demyelinating polyneuropathy, GBS

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References


Ragazzi NL, Kolahi AA, Nejadghaderi SA. Global, regional, and national burden of Guillain–Barré syndrome and its underlying causes from 1990 to 2019. J Neuroinflammation. 2021;18:264.

Abu Rumeileh S, Abdelhak A, Foschi M, Tumani H, Otto M. Guillain-Barré syndrome spectrum associated with COVID-19: an up-to-date systematic review of 73 cases. J Neurol. 2021;268:1133-70.

Lascano AM, Epiney JB, Coen M, Serratrice J, Bernard Valnet R, Lalive PH et al. SARS-CoV-2 and Guillain-Barré syndrome: AIDP variant with a favourable outcome. Eur J Neurol. 2020;27(9):1751-3.

Sedaghat Z, Karimi N. Guillain Barre syndrome associated with COVID-19 infection: A case report. J Clin Neurosci. 2020;76:233-5.

Shoraka S, Ferreira MLB, Mohebbi SR and Ghaemi A. SARS-CoV-2 Infection and Guillain-Barré Syndrome: A Review on Potential Pathogenic Mechanisms. Front. Immunol. 2021;12:674922.

Finsterer J, Scorza FA, Scorza CA. Post SARS-CoV-2 vaccination Guillain-Barre syndrome in 19 patients. Clinics (Sao Paulo). 2021;76:e3286.

Zemke AM, Boles LH, Gillespie M, Viljoen JM. Guillain-Barré syndrome hyponatremia: is it SIADH or pseudohyponatremia? Oxf Med Case Reports. 2018;2018(7):omy042.

James J, Jose J. Syndrome of Inappropriate Secretion of Antidiuretic Hormone Preceding Guillain-Barré Syndrome. J Clin Diagn Res. 2017;11(9):OD16-7.

Penney MD, Murphy D, Walters G. Resetting of osmoreceptor response as cause of hyponatraemia in acute idiopathic polyneuritis. Br Med J. 1979;2(6203):1474-6.

Nguyen MK, Rastogi A, Kurtz I. True hyponatremia secondary to intravenous immunoglobulin. Clin Exp Nephrol. 2006;10(2):124-6.