A 12-year-old unvaccinated boy presents with sore throat and a gray pharyngeal membrane. Three weeks after symptom onset, he develops palatal weakness and distal paresthesias. Vital signs show BP 118/76 mmHg, HR 92/min, RR 18/min, temperature 37.2°C, and SpO2 98% on room air. Nerve conduction studies demonstrate prolonged distal latencies with preserved conduction velocities. Gag reflex remains intact. Which of the following best explains this neurologic complication?
- A)Autoantibodies against acetylcholine receptors
- B)Immune complex vasculitis of medium sized arteries
- C)Direct viral destruction of anterior horn cells
- D)Glutamate mediated excitotoxicity
- E)Toxin mediated demyelinating peripheral neuropathyGABARITO
Explicação
Corynebacterium diphtheriae toxin can lead to delayed peripheral neuropathy due to toxin mediated injury and demyelination after the acute pharyngeal illness. Cranial neuropathies and peripheral weakness may follow the initial infection. Ver explicação completa e trilha adaptativa →