The confocal microscopy of the cornea in post-COVID syndrome; the clinical observation

IF 1.1 Q4 IMMUNOLOGY Immunopathologia Persa Pub Date : 2022-04-17 DOI:10.34172/ipp.2022.31338
M. Lukashenko, L. Soprun, Anna Bregovskaya, N. Gavrilova, V. I. Utekhin
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Abstract

One of the most important complications of the post-COVID-19 syndrome may be a small fiber neuropathy, which cannot be evaluated by a routine electroneuromyography. Confocal microscopy of the cornea (CCM) may be a promising method for early neuropathy verification. To study the possibility of the small fiber neuropathy evaluation using the CCM in a patient with the post-COVID-19 condition. The patient is a female of 61 years old, which suffered from a COVID-19 infection in October 2020. After a month, she noted the presence of myalgia and polyneuropathy. A year after the onset of the disease, in addition to myalgia, headaches, neuropathy pain, the patient also experienced bowel disorders and stomach aches, which cannot be explained with an alternative diagnosis. The patient underwent CCM to assess the structure of nerve fibers to prove the presence of the small fiber neuropathy as a complication of the COVID-19 infection. The presence of the small fiber neuropathy was evaluated in the patient as well as enlarged Langerhans cells in the cornea. Considering the pivotal role of these cells in the immunological processes, the "activated" dendritic cells in post-COVID-19 patients may serve as another evidence of the autoimmune nature of this complication and possibly, a method for the monitoring treatment effectiveness of this disease. In this clinical case of a 61-year-old patient with the post-COVID-19 syndrome, the possibility of application of the confocal microscopy of the cornea for the diagnosis of neuropathy of small fibers and monitoring of the patient›s condition is shown.
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covid - 19综合征后角膜共聚焦显微镜观察临床观察
covid -19后综合征最重要的并发症之一可能是小纤维神经病变,无法通过常规神经肌电图评估。角膜共聚焦显微镜(CCM)可能是一种有希望的早期神经病变验证方法。探讨CCM在新冠肺炎后患者小纤维神经病变评估中的可行性。患者为女性,61岁,于2020年10月感染新冠肺炎。一个月后,她注意到肌痛和多发性神经病的出现。发病一年后,除了肌痛、头痛、神经性疼痛外,患者还出现了肠道紊乱和胃痛,这些症状无法用其他诊断来解释。患者行CCM以评估神经纤维结构,以证明存在小纤维神经病作为COVID-19感染的并发症。评估患者是否存在小纤维神经病变以及角膜中朗格汉斯细胞的扩大。考虑到这些细胞在免疫过程中的关键作用,covid -19后患者的“活化”树突状细胞可能作为该并发症自身免疫性质的另一个证据,并可能成为监测该疾病治疗效果的一种方法。在这个61岁的covid -19后综合征患者的临床病例中,显示了应用角膜共聚焦显微镜诊断小纤维神经病变和监测患者病情的可能性。
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CiteScore
1.70
自引率
0.00%
发文量
65
审稿时长
3 weeks
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