Guillain-Barre Syndrome and Hemophagocytic Lymphohistiocytosis Following COVID-19: A Case Report

Abstract

The Severe acute respiratory syndrome-Coronavirus-2 (SARS-CoV-2) infection causes a wide range of neurologic and hematologic manifestations. Herein, we report the case of a 69-year-old Indian male with concurrent Guillain-Barre syndrome (GBS) and hemophagocytic lymphohistiocytosis (HLH) after a bout of COVID-19. He initially presented with acute ascending paraparesis and fever. Nerve conduction studies revealed axonal degeneration, affecting both motor and sensory nerves, and cerebrospinal fluid analysis revealed albuminocytologic dissociation. Thus, a diagnosis of GBS was made. Considering the fever, bicytopenia, elevated levels of triglycerides and ferritin, and bone marrow alterations, a diagnosis of HLH was made. Intravenous immunoglobulin therapy was administered, which produced a good clinical response.

Keywords

• guillain-barre syndrome
• hemophagocytic lymphohistiocytosis
• sars-cov-2 infection
• hyperinflammation
• molecular mimicry