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Journal of Pediatric Neurology 2021; 19(06): 449-451
DOI: 10.1055/s-0041-1722927
Case Report

Plasma Exchange in Refractory Acute Disseminated Encephalomyelitis Associated with COVID-19: Technical Challenges in a Developing Country

Sumantra Kumar Raut
1   Department of Pediatrics, Medical College, Kolkata, West Bengal, India
,
Mihir Sarkar
1   Department of Pediatrics, Medical College, Kolkata, West Bengal, India
,
Arpita Khemka
1   Department of Pediatrics, Medical College, Kolkata, West Bengal, India
,
Kalpana Datta
1   Department of Pediatrics, Medical College, Kolkata, West Bengal, India
,
Mousumi Nandi
1   Department of Pediatrics, Medical College, Kolkata, West Bengal, India
,
Durba Biswas
2   Department of Immunology, Hematology and Blood Transfusion, Kolkata, West Bengal, India
,
Dipankar Sutar
1   Department of Pediatrics, Medical College, Kolkata, West Bengal, India
,
Arundhati Banerjee
1   Department of Pediatrics, Medical College, Kolkata, West Bengal, India
› Author Affiliations Funding None.
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Abstract

Evaluation of acquired demyelinating syndrome (ADS) without diagnostic biomarkers results in diagnostic and therapeutic challenges in pediatric population. Immune-mediated ADS of childhood responds well to steroid and intravenous immunoglobulin (IVIg) and in refractory cases with plasma exchange. Novel coronavirus disease 2019 (COVID-19) coinfection in such cases imposes technical challenges in management. An 11-year-old girl with quadriparesis and loss of vision and a magnetic resonance imaging (MRI) brain showing acute demyelinating encephalomyelitis (ADEM) and cerebrospinal fluid examination being noncontributory responded well with plasma exchange after failing steroid and IVIg is described. Coinfection with COVID-19 mandating personal protection in a temperate country imposed technical challenges in her management.

Keywords

COVID-19 - ADEM - PLEX - NMO–MOG demyelination


Publication History

Received: 08 October 2020

Accepted: 21 December 2020

Article published online:
08 February 2021

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