Dilek İNCE, Ayşe Semra HIZ, Uluç YİŞ, Ayşen GÖK, Döndü ÜLKER ÜSTEBAY

SARS-CoV-2 ile ilişkili polinöritis kraniyalis multisistemik tutulumun habercisi olabilir mi?

Pandemiye yol açan, hızla yayılarak insan sağlığını tehdit eden viral bir hastalık olan Covid-19 ile ilgili dünya genelinde paylaşılan veriler değerlendirildiğinde, çocuklarda klinik tablonun daha hafif seyirli olduğu görülmektedir. Bununla birlikte altta yatan kronik hastalığı olan ve bağışıklığı baskılanmış çocuklarda ağır seyreden olgular bildirilmiştir. SARS-CoV-2 enfeksiyonu öncelikle solunum yolunu hedef alsa da birçok sistem etkilenmektedir. Nörolojik tutulumun virüsün santral sinir sistemine doğrudan nörotropizmine bağlı olabileceği gibi, enfeksiyonun neden olduğu anormal immün yanıt, pıhtılaşma bozuklukları, hipoksi gibi sinir sistemini etkileyebilen nedenlerle de oluşabildiği tahmin edilmektedir. Bu yazıda Ewing sarkom tanısı ile izlenirken, Covid-19 ilişkili polinöritis kraniyalis gelişen ve nörolojik bulguların görülmesinden yedi gün sonra multisistem inflamatuar sendrom tablosu oluşan bir olgu kraniyal sinir tutulumunun ender görülmesi ve katastrofik bir seyrin habercisi olması açısından nadir görülmesi nedeniyle sunulmaktadır.

COULD POLYNEUTRITIS CRANIALIS-RELATED SARS-COV-2 BE A PRECURSOR OF MULTISYSTEMIC INVOLVEMENT?

When world wide data associated with Covid-19 -a viral disease threatening human health by spreading rapidly and eventually leading to pandemia- are evaluated, clinical picture is observed to be milder in children. Nevertheless, severe cases in children with underlying chronic disease and immunosuppression have been reported. Although SARS-CoV-2 infection targets respiratory tract primarily, many systems are affected. While the neurological involvement can directly depend on the neurotropism of CNS of virus, it is estimated that it can also be formed owing to reasons that can affect nervous system such as hypoxia, abnormal immune response resulting from infection and coagulopathies. In this report, a case of Ewing sarkom, who developed polyneuritis cranialis and presented with multisystemic inflammatory syndrome seven days after the development of neurological findings, is presented due to rarity of cranial nerve involvement and being a precursor of a catastrophic course.

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