Encefalitis autoinmune seronegativa asociada a COVID-19: reporte de caso
DOI:
https://doi.org/10.20453/rnp.v87i2.5254Palavras-chave:
encefalitis autoinmune, enfermedad por coronavirus 2019 (COVID-19), manifestación neurológica, inmunoterapia, anticuerpoResumo
Es sabido que la encefalitis autoinmune se asocia temporalmente con diferentes infecciones virales, aun cuando, hasta la fecha, su asociación con la COVID-19 se ha descrito raramente. Se presenta el caso de una mujer de 47 años, autosuficiente, sin antecedentes de vacunación contra COVID-19, se presentó al servicio de emergencia de un hospital local con síntomas respiratorios y prueba positiva de antígeno para infección por SARS-CoV-2 y síntomas de heteroagresividad, mutismo acinético, crisis epilépticas e hiperreflexia. Las pruebas infecciosas, autoinmunes y neoplásicas, incluido el panel de encefalitis autoinmune en LCR, fueron negativas. Se administró tratamiento empírico con metilprednisolona e inmunoglobulina por dos semanas sin respuesta terapéutica, por lo que se inició tratamiento con ciclofosfamida: la evolución clínica fue favorable, pero con un severo trastorno neurocognitivo residual. El hecho de que la presentación inicial del caso fue severa y no respondió al tratamiento de primera línea, a pesar de ser empleado oportunamente, podría indicar una mayor probabilidad de secuelas a largo plazo.
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Copyright (c) 2024 Miguel A Vences, Maria Fe Albujar, Marcela Araujo, Diego Canales, Edu Cardenas, Ebelin Barja, Arturo Alvarez, Diego Urrunaga-Pastor
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