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Case report: A novel case of COVID-19 triggered tumefactive demyelinating lesions in one multiple sclerosis patient

Authors :
Jinghan Hu
Leiyun Huang
Zengyun Qiu
Yongzhen Liu
Kaiming Shen
Bin Tang
Jing Qian
Source :
Frontiers in Neuroscience, Vol 17 (2023)
Publication Year :
2023
Publisher :
Frontiers Media S.A., 2023.

Abstract

The epidemic of COVID-19 is mainly manifested by respiratory symptoms caused by SARS-CoV-2 infection. Recently, reports of central nervous system diseases caused or aggravated by SARS-CoV-2 infection are also increasing. Thus, the COVID-19 pandemic poses an unprecedented challenge to the diagnosis and management of neurological disorders, especially to those diseases which have overlapping clinical and radiologic features with each other. In this study, a 31-year-old female patient had been diagnosed with relapsing–remitting multiple sclerosis (RRMS) initially and subsequently developed tumefactive demyelinating lesions (TDLs) following an infection with SARS-CoV-2. After immunotherapy (glucocorticoid pulses), a significant improvement was observed in her both clinical and radiological characteristics. The patient was started on disease-modifying therapy (DMT) with teriflunomide after cessation of oral glucocorticoids. Following two months of DMT treatment, the imaging follow-up revealed that the patient’s condition continued to deteriorate. This case was characterized by the transformation of a multiple sclerosis patient (MS) infected with SARS-CoV-2 into TDLs and the ineffectiveness of DMT treatment, which added complexity to its diagnosis and treatment. The case also gave us a hint that SARS-CoV-2 has a potential contributory role in inducing or exacerbating demyelinating diseases of the central nervous system that warrants further investigation.

Details

Language :
English
ISSN :
1662453X
Volume :
17
Database :
Directory of Open Access Journals
Journal :
Frontiers in Neuroscience
Publication Type :
Academic Journal
Accession number :
edsdoj.1bd3d9f7486c4103a5a35acf33bae26f
Document Type :
article
Full Text :
https://doi.org/10.3389/fnins.2023.1287480