SARS-CoV-2 infection associated with diplopia and anti-acetylcholine receptor antibodies

Álvarez, A.I. Pérez; Cuervo, C. Suárez; Menéndez, S. Fernández

doi:10.1016/j.nrleng.2020.04.003

Cited by 14 publications

(19 citation statements)

References 6 publications

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“…To date, there were reports of eight such patients published in the literature. [5][6][7][8][9][10] Clinical features of all nine patients, including one described in this report, are summarised in table 1. The Majority were aged above 50 years (67%) and suffered mild COVID-19 (75%).…”

Section: Discussionmentioning

confidence: 99%

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Temporal association between SARS-CoV-2 and new-onset myasthenia gravis: is it causal or coincidental?

Reddy

Osman

et al. 2021

BMJ Case Rep

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Several case reports of COVID-19 in patients with myasthenia gravis (MG) have been documented. However, new-onset autoimmune MG following COVID-19 has been reported very rarely. We report one such case here. A 65-year-old man presented to us with dysphagia 6 weeks following mild COVID-19. He was evaluated and diagnosed as antiacetylcholine receptor antibody (AchR) positive, non-thymomatous, generalised MG. He subsequently developed myasthenic crisis and improved after treatment with intravenous immunoglobulin, prednisolone and pyridostigmine. Systematic literature review showed eight more similar cases. Analysis of all cases including the one reported here showed these features: mean age 55.8 years, male gender (5), time interval between COVID-19 and MG (5–56 days), generalised (5), bulbar and/or ocular symptoms (4), anti-AchR antibodies (7) and antimuscle-specific kinase antibodies (2). All have improved with immunotherapy. Although, many hypothesis are proposed to explain causal relationship between the two, it could as well be sheer coincidence.

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Section: Discussionmentioning

confidence: 99%

“…[2][3][4] New-onset autoimmune MG has also been reported, although rarely following COVID-19. [5][6][7][8][9][10] We describe one such patient with new-onset autoimmune MG following COVID-19 and review the current literature.…”

Section: Introductionmentioning

confidence: 99%

Temporal association between SARS-CoV-2 and new-onset myasthenia gravis: is it causal or coincidental?

Reddy

Osman

et al. 2021

BMJ Case Rep

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“…al., 2020). Outros sintomas citados frequentemente são a diplopia (Álvarez, Cuervo & Menéndez, 2020;Guo et. al, 2020), sensação de corpo estranho (Daruich & Bremond-Gignac 2020;Selvaraj, Sacchetti & Dapaah-Afriyie 2020), a visão turva e a presença de secreções aquosas e/ou mucosas (Lantos, et.…”

Section: Discussionunclassified

“…Os estudos também descrevem a associação de tratamento sistêmico como adjuvante, considerando o uso de antivirais como o Lopinavir associado ao Ritonavir , o Umifenovir, o Oseltamivir e o gel de Ganciclovir , além da hidroxicloroquina e sua associação com azitromicina . A utilização de compressas frias oculares também foi uma técnica sugerida para o alívio dos sintomas (Álvarez, et. al., 2020;Férnandez-Domíngues, et.…”

Section: Discussionunclassified

Manifestações oculares da COVID-19: Uma revisão narrativa de literatura

Biberg-Salum

Lyrio

Canale

2021

RSD

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Objetivos: Este artigo tem como objetivo analisar as manifestações oftalmológicas da COVID-19 descritas na literatura, assim como a duração dos sintomas e a relação temporal entre o início das manifestações oculares e das manifestações sistêmicas. Métodos: É uma revisão narrativa de literatura, utilizando os seguintes descritores: infecção por coronavírus, betacoronavírus, COVID-19, doenças oculares e manifestações oculares, sendo utilizadas as bases eletrônicas LILACS e MEDLINE, buscando artigos publicados entre os meses de maio a agosto de 2020. Resultados: A pesquisa inicial identificou 824 artigos, sendo que 14 cumpriam os critérios de inclusão. Dos casos relatados de ceratoconjuntivite, as manifestações oculares mais descritas são a hiperemia conjuntival, monocular ou binocular, e o edema de pálpebra. Outros sintomas que podem aparecer com frequência são a diplopia, sensação de corpo estranho, visão turva e a presença de secreções aquosas e viscosas. Conclusão: Conclui-se que a principal manifestação ocular associada à presença do SARS-CoV-2 é a hiperemia conjuntival, com duração variável entre 2 e 30 dias.

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“…For example, nicotinic acetylcholine α7 receptors are potentially involved in modulating the secretion of proinfl ammatory cytokines (and, thus, in suppressing the "cytokine storm"). Such clinical manifestations of COVID-19 as anosmia and thromboembolic complications may also be linked with dysfunction of the nicotinic cholinergic system [25]. Furthermore, infection with SARS-CoV-2 is associated with formation of antibodies to acetylcholine receptors [26].…”

Section: Introductionmentioning

confidence: 99%