Abstract
RATIONALE: Patients 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 CONCERNS: A 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. DIAGNOSIS: GBS/ATM overlap syndrome secondary to COVID-19. INTERVENTIONS: Five 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. OUTCOMES: The 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. LESSONS: COVID-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.