ADEM post-Sars-CoV-2 infection in a pediatric patient with Fisher-Evans syndrome

Abstract

Introduction Sars-CoV-2 is a single-strained RNA virus belonging to Coronaviridae’s family. In pediatric age, the majority of patients is asymptomatic; however, several neurological manifestations associated with Sars-CoV-2 infection have been detected in a percentage of cases ranging from 17.3 to 36.4%. Acute disseminated encephalomyelitis (ADEM) has been recently included among the potential complications of Sars-Cov2 infection. The available data regarding pediatric patient show only one case. Case report We present a case regarding a 6-year-old patient suffering from Fisher-Evans syndrome who was given sirolimus and thalidomide therapy. After 10 days since the first positive nasopharyngeal swab for Sars-CoV-2, in which he had no symptoms, he presented an episode of generalized tonic-clonic seizure with spontaneous resolution. The patient underwent MRI which showed the typical picture of acute disseminated encephalomyelitis. His clinical course was favorable, with a good response to cortisone therapy and a progressive improvement of the neuroradiological and electroencephalographic picture. Conclusions According to our knowledge, this is the second case of an acute disseminated encephalomyelitis following SARS-CoV-2 infection in a pediatric patient, characterized by monosymptomatic onset, in which the immunosuppressive therapy practiced for the Fisher-Evans syndrome has probably contributed to a favorable evolution of ADEM, in contrast to other case described in the literature.

Cluster-based text mining for extracting drug candidates for the prevention of COVID-19 from the biomedical literature

“…However, most of these articles point to sirolimus as an immunosuppressive drug and thus could be as a potential medicine for the treatment of immunocompromised status in COVID-19 patients. 42 , 43 Our docking results also confirmed that sirolimus has the second highest affinity against SARS-CoV-2 spike proteins.…”

COVID-19 and the Pandemic-Related Aspects in Pediatric Demyelinating Disorders

“…Eight children, ranging in age from 17 months to 13 years, were reported to have ADEM in association with SARS-CoV-2 infection 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 . There were four females, three males, and one not specified [ 6 , 13 ].…”

Long-term outcomes of COVID-19 infection in children and young people: a systematic review and meta-analysis

“…Articles were translated from Norwegian, Russian, and Mandarin. 38 were case reports 23,33,36,41,43,47,48,51,52,55,57,[60][61][62]64,[66][67][68][69][70]72,78,80,[85][86][87]89,92,[98][99][100][101]107,108,110,112 . Of those that were not case reports, most were cohort studies (26) 23,24,33,36,41,43,47,48,51,52,55,57,[60][61][62][64]…”

“…11 of these recruited from hospital settings 26,30,32,53,56,79,88,95,97,103,104 and six recruited from the community 74,81,82,91,94,114 . 14 were cohort studies 26,30,53,56,81,82,88,91,94,95,97,103,104,114 , and three were longitudinal case series 32,74,78 (all three case series contained at least 70 participants).…”