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PMC:7288617 JSONTXT 19 Projects

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Id Subject Object Predicate Lexical cue
T1 0-75 Sentence denotes Miller Fisher syndrome diagnosis and treatment in a patient with SARS-CoV-2
T2 78-86 Sentence denotes Abstract
T3 87-316 Sentence denotes This case report describes the clinical characteristics of a 50-year-old woman that developed SARS-CoV-2 pneumonia and was admitted at the COVID-19 dedicated unit where she developed neurological symptoms 10 days after admission.
T4 317-529 Sentence denotes After neurological examination, including a panel of blood cerebrospinal fluid biomarkers, a diagnosis of Miller Fisher syndrome (MFS) was hypothesized and intravenous immunoglobulin therapy (IVIG) was initiated.
T5 530-735 Sentence denotes Fourteen days after the start of IVIG treatment, the patient has been discharged at home with the resolution of respiratory symptoms and only minor hyporeflexia at the lower limbs, without any side effect.
T6 737-952 Sentence denotes The diffusion of the novel coronavirus SARS-CoV-2 has rapidly spread worldwide, with several cases requiring intensive care and hospitalization because of the severe respiratory symptoms requiring assisting devices.
T7 953-1108 Sentence denotes Miller Fisher syndrome (MFS), a variant of Guillain-Barré syndrome (GBS), is characterized by the clinical triad of ophthalmoplegia, ataxia, and areflexia.
T8 1109-1242 Sentence denotes About 60% of the above mentioned autoimmune syndromes can be infection-related by humoral and cellular cross-reactivity (Pusch et al.
T9 1243-1374 Sentence denotes 2018), most frequently gastrointestinal (Campylobacter jejuni) or respiratory tract infections, including influenza (Sellers et al.
T10 1375-1381 Sentence denotes 2017).
T11 1382-1607 Sentence denotes A previously healthy 50-year-old female, who worked as a healthcare assistant in an assisted living community, was admitted to the hospital with a diagnosis of bilateral pneumonia as a consequence of the SARS-CoV-2 infection.
T12 1608-1728 Sentence denotes The first symptoms 6 days before the admission were fever and cough, and a significant alteration of taste was reported.
T13 1729-1914 Sentence denotes In the COVID-19 protected area, she was treated with antiviral therapy (lopinavir + ritonavir) for 14 days, hydroxychloroquine for 10 days, antibiotic therapy, and oxygen support (35%).
T14 1915-2068 Sentence denotes Ten days after hospital admission, the pulmonary function improved, but the patient developed neurological signs such as diplopia and facial paresthesia.
T15 2069-2369 Sentence denotes The first neurological examination found walking impairment due to ataxia, ophthalmoplegia with diplopia in vertical and lateral gaze, left upper arm cerebellar dysmetria, generalized areflexia, mild lower facial defects, and mild hypoesthesia in the left mandibular and maxillary branch of the face.
T16 2370-2508 Sentence denotes To exclude a posterior circulation stroke, a magnetic resonance imaging (MRI) of the brain was performed, which revealed no abnormalities.
T17 2509-2664 Sentence denotes The results of routine blood chemistry tests, anti-HIV, anti-HBV, and anti-HCV, and a panel of serological tests of autoimmune disorders were unremarkable.
T18 2665-2760 Sentence denotes The cerebrospinal fluid (CSF) analysis revealed clear CSF, normal pressure, and no blood cells.
T19 2761-2806 Sentence denotes The CSF/serum glucose ratio was 80/110 mg/dL.
T20 2807-2895 Sentence denotes CSF protein concentration was 74.9 mg/dL, higher compared with normal values < 45 mg/dL.
T21 2896-3115 Sentence denotes CSF culture and polymerase chain reaction (PCR) for possible organisms, such as bacteria, Mycobacterium tuberculosis, fungi, Herpes viruses, Enteroviruses, Japanese B virus, and Dengue viruses, yielded negative results.
T22 3116-3252 Sentence denotes Neurophysiological evaluation, as electroneuromyography, was not possible because of the limitations due to the COVID-19 protected area.
T23 3253-3372 Sentence denotes A panel of AGAbs, including anti-GM1, anti-GM2, anti-GM3, anti-GD1a, anti-GD1b, anti-GT1b, and anti-GQ1b, was negative.
T24 3373-3508 Sentence denotes Based on the clinical presentation and CFS findings, an intravenous immunoglobulin (IVIG) therapy was initiated at 0.4 g/kg for 5 days.
T25 3509-3693 Sentence denotes The neurological symptoms resolved 7 days after the start of IVIG treatment, with complete recovery of diplopia and dysmetria, and the patient was able to walk without signs of ataxia.
T26 3694-3803 Sentence denotes After the acute phase, the patient remained in the COVID-19 protected area still needing respiratory support.
T27 3804-3884 Sentence denotes No side effects were reported for the use of intravenous immunoglobulin therapy.
T28 3885-4065 Sentence denotes Fourteen days after the start of IVIG treatment, the patient has been discharged at home with the resolution of respiratory symptoms and only minor hyporeflexia at the lower limbs.
T29 4067-4077 Sentence denotes Discussion
T30 4078-4287 Sentence denotes The clinical presentation of the reported case, and CSF analysis showing a picture of albumin-cytological dissociation, suggested the diagnosis of MFS as previously described in the literature (Wakerley et al.
T31 4288-4294 Sentence denotes 2014).
T32 4295-4491 Sentence denotes The novelty of this case is represented by the diagnosis of MFS in a COVID-19 patient and by the clinical suggestion of treating neurological complications with intravenous immunoglobulin therapy.
T33 4492-4576 Sentence denotes Such neurological complications are common in respiratory infections (Sellers et al.
T34 4577-4682 Sentence denotes 2017); therefore, a cross-reactivity also for the new SARS-CoV-2 was speculated and reported (Zhao et al.
T35 4683-4735 Sentence denotes 2020) as for SARS-CoV affected patients (Baig et al.
T36 4736-4742 Sentence denotes 2020).
T37 4743-4849 Sentence denotes We did not find any presence of anti-GQ1b, usually explaining the symptoms of the disease (Wakerley et al.
T38 4850-4856 Sentence denotes 2014).
T39 4857-4968 Sentence denotes However, negative results for anti-GQ1b tests have been previously reported (Wattanasit and Sathirapanya 2020).
T40 4969-5119 Sentence denotes The particular cranial polyradiculoneuritis with the involvement of the facial and trigeminal nerve is well-known in MFS and MFS variants (Polo et al.
T41 5120-5141 Sentence denotes 1992; Wakerley et al.
T42 5142-5301 Sentence denotes 2014), and in the reported case, it was found being associated to an altered sense of taste, which is an uncommon feature of MFS but well-reported in COVID-19.
T43 5302-5426 Sentence denotes IVIG was found to be effective and safe to treat the reported neurological symptoms, showing complete recovery after 7 days.
T44 5427-5692 Sentence denotes In conclusion, this case report describes the characteristics of a MFS/cranial polyneuritis in a patient with COVID-19, and the clinical responses to intravenous immunoglobulin therapy, suggesting possible diagnosis and treatment options in this peculiar condition.