{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:46:30Z","timestamp":1792115190014,"version":"4.4.0"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T00:00:00Z","timestamp":1728000000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The Coronavirus disease 19 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a threat to human health. Although the COVID-19 pandemic is finished, some peoples are still suffering from this disease. Herein, we report the first case of SARS-CoV-2-associated Guillain-Barr\u00e9 syndrome (GBS) presenting as polyneuritis cranialis (PNC) and acute panautonomic neuropathy (APN) variants, accompanied by mild encephalitis\/encephalopathy with a reversible splenial lesion (MERS) and hyponatremia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>A 32-year-old female patient with symptoms indicating multiple cranial nerve involvement, as well as sympathetic and parasympathetic nervous system dysfunction, was diagnosed as SARS-CoV-2-associated GBS presenting as PNC and APN variants, accompanied by MERS and hyponatremia. Following treatment with immunoglobulin, methylprednisolone, and symptomatic care, the patient\u2019s inflammatory cytokines and serum sodium became normal. However, some residual symptoms such as postural hypotension, fatigue, and mild dysarthria persisted at the 9-month follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This case highlights the unique presentation of SARS-CoV-2 infection. The involvement of both the central nervous system (CNS) and the peripheral nervous system (PNS) in this case underscores the complex neurological manifestations of COVID-19. Although the exact underlying pathogenesis of this case is unclear, inflammatory cytokines, particularly IL-6, may be implicated. Further research is needed to better understand the mechanisms underlying these complications and to optimize treatment strategies for affected patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2024.1458231","type":"journal-article","created":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T04:22:47Z","timestamp":1728015767000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Case report: Rare Guillain-Barr\u00e9 syndrome variants and mild encephalitis\/encephalopathy with a reversible splenial lesion as the para-infectious manifestations of SARS-CoV-2 infection"],"prefix":"10.3389","volume":"15","author":[{"given":"Wei","family":"Si","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanrui","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganqin","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,10,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e16094","DOI":"10.1111\/ene.16094","article-title":"Guillain-Barr\u00e9 syndrome and SARS-CoV-2 infection: a systematic review and meta-analysis on a debated issue and evidence for the \u2018Italian factor\u2019","volume":"31","author":"Censi","year":"2024","journal-title":"Eur J Neurol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000009619","article-title":"Miller Fisher syndrome and polyneuritis cranialis in COVID-19","volume":"95","author":"Guti\u00e9rrez-Ortiz","year":"2020","journal-title":"Neurology"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.18690\/actabiomed.251","article-title":"Polyneuritis cranialis related to SARS-CoV-2 infection: a case report","volume":"16","author":"Gradi\u0161nik","year":"2023","journal-title":"Acta Medico-Biotechnica"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e875","DOI":"10.1002\/iid3.875","article-title":"COVID-19 as a trigger of Guillain-Barr\u00e9 syndrome: A review of the molecular mechanism","volume":"11","author":"Malekpour","year":"2023","journal-title":"Immun Inflammation Dis"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awaa240","article-title":"The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings","volume":"143","author":"Paterson","year":"2020","journal-title":"Brain"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbih.2022.100578","article-title":"Guillain-Barr\u00e9 syndrome associated with COVID-19: A systematic review","volume":"28","author":"Pimentel","year":"2023","journal-title":"Brain Behav Immun Health"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.cyto.2020.155404","article-title":"Cytokine storm induced by SARS-CoV-2 infection: The spectrum of its neurological manifestations","volume":"138","author":"Thepmankorn","year":"2021","journal-title":"Cytokine"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3390\/covid3020013","article-title":"A case of COVID-related MERS (clinically mild encephalitis\/encephalopathy with a reversible splenial lesion) with a typical imaging course and hyponatremia in adults\u2014A case report and literature review","volume":"3","author":"Tokano","year":"2023","journal-title":"COVID"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.971432","article-title":"Case report: Mild encephalitis with a reversible splenial lesion associated with SARS-CoV-2 infection in a patient with MYRF variant","volume":"10","author":"Saito","year":"2022","journal-title":"Front Pediatr"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2020.07.009","article-title":"Mild encephalopathy with reversible splenium lesion (MERS) in a patient with COVID-19","volume":"79","author":"Kakadia","year":"2020","journal-title":"J Clin Neurosci"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1002\/jgf2.646","article-title":"A case of mild encephalitis associated with COVID-19","volume":"24","author":"Nagae","year":"2023","journal-title":"J Gen Fam Med"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1322302","article-title":"Case report: Clinically mild encephalitis\/encephalopathy with a reversible splenial lesion: an autopsy case","volume":"14","author":"Hayashi","year":"2024","journal-title":"Front Neurol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13051397","article-title":"Is COVID-19 infection a multiorganic disease? Focus on extrapulmonary involvement of SARS-coV-2","volume":"13","author":"Duloquin","year":"2024","journal-title":"J Clin Med"},{"key":"B14","doi-asserted-by":"publisher","first-page":"e36421","DOI":"10.7759\/cureus.36421","article-title":"Mild encephalopathy with partial reversible splenium lesion associated with SARS-coV-2 infection","volume":"15","author":"Reyes","year":"2023","journal-title":"Cureus"},{"key":"B15","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1159\/000322238","article-title":"Hyponatremia and inflammation: the emerging role of interleukin-6 in osmoregulation","volume":"118","author":"Swart","year":"2011","journal-title":"Nephron Physiol"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2024.1458231\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T04:22:49Z","timestamp":1728015769000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2024.1458231\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,4]]},"references-count":15,"alternative-id":["10.3389\/fimmu.2024.1458231"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2024.1458231","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,4]]},"article-number":"1458231"}}