• Ruomeng Chen, Liang Wang, Binbin Wang, Xiujuan Song, and Xiaoyun Liu.
• Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China.
• Medicine (Baltimore). 2024 Nov 8; 103 (45): e40346e40346.

RationalePatients with chronic immune diseases, such as idiopathic thrombocytopenic purpura (ITP), should be alert for Guillain-Barre/acute transverse myelitis (GBS/ATM) overlap syndrome after infection with coronavirus disease 2019 (COVID-19).Patient ConcernsA 65-year-old male with an ITP history, who presented with limb numbness and weakness, urinary retention, right peripheral facial paralysis, and diplopia 2 weeks after being diagnosed with COVID-19.DiagnosisGBS/ATM overlap syndrome secondary to COVID-19.InterventionsFive days intravenous immune globulin, methylprednisolone (500 mg) was added for treatment. He was discharged with medicine and continued to take Methylprednisolone tablets (60 mg/d), Eltrombopag olamine (25 mg 1/d), Mecobalamine tablets, vitamin B1, and rehabilitation treatment outside the hospital.OutcomesThe patient significantly improved after initial treatment, he returned to normal life after 8 weeks. Five months later, he was infected with COVID-19 for the second time, exhibiting only symptoms of upper respiratory tract infection and no other discomfort.LessonsCOVID-19 infection can lead to secondary myelitis and GBS, and GBS/ATM overlap syndrome is rare, but patients are significantly better after immunization and hormone therapy.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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