COVID-19-associated Guillain–Barrè Syndrome and Urinary Dysfunction: A case report

Marilena Gubbiotti , Wally Mahfouz , Anastasios D. Asimakopoulos , Ludovica Durante , Giacomo Maria Pirola , Daniele Castellani , Emanuele Rubilotta
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引用次数: 1

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral infection can cause multiple systemic and neurological complications, including Guillain–Barrè Syndrome (GBS). In this report we describe for the first time, urinary dysfunction in a patient with COVID-19. We reported a 41-years-old female patient with complaints of an increased generalized muscular weakness associated with progressive difficulty in walking. Four days earlier, patient complained of fever, diarrhea, and general weakness, and the RT-PCR was positive for COVID-19 infection. Due to the worsening of neurological symptoms, a neurophysiological examination on nervous conduction was performed and the diagnosis was suggestive of GBS. Two weeks later, patient developed two consecutive episodes of acute urinary retention that requested the placement of indwelling transurethral catheter. Patient started assuming selective alpha-1 adrenergic antagonist in association with 4 clean intermittent catheterization/die. Four months later, women continued the therapy and the ultrasound evaluation revealed non-pathologic post-void residual volume. Therefore, patient started to void spontaneously again and alpha-blockers were discontinued. We report for the first time a case of severe voiding disorder in a patient with COVID-19 associated GBS. Timely bladder drainage should be adopted to avoid irreversible detrusor damage.

covid -19相关Guillain-Barrè综合征和泌尿功能障碍1例报告
严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)病毒感染可引起多种全身和神经系统并发症,包括Guillain-Barrè综合征(GBS)。在本报告中,我们首次描述了COVID-19患者的泌尿功能障碍。我们报告了一位41岁的女性患者,她的主诉是全身肌肉无力增加并伴有进行性行走困难。4天前,患者出现发热、腹泻、全身乏力等症状,RT-PCR检测为COVID-19感染阳性。由于神经系统症状加重,对神经传导进行神经生理检查,诊断提示GBS。两周后,患者出现连续两次急性尿潴留,需要放置经尿道留置导尿管。患者开始假设选择性α -1肾上腺素能拮抗剂与4次清洁间歇置管/死亡有关。四个月后,妇女继续治疗,超声评估显示非病理性空后残留体积。因此,患者再次开始自发排空,并停用α受体阻滞剂。我们首次报道一例与COVID-19相关的GBS患者出现严重排尿障碍。应及时采取膀胱引流,避免不可逆的逼尿肌损伤。
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