The 77-year-old Japanese had already survived Covid 19. But weeks later he ended up in the hospital again. Doctors diagnose restless anal syndrome. A case report.
Covid-19 has many symptoms and is versatile like a chameleon. Cough and fever are the most common complaints, but there are also rare, sometimes strange complaints such as “black fungus” or Covid toes. Now the case of a 77-year-old Japanese is making the rounds, who suddenly developed anal problems after his Covid-19 illness.
The man had to be treated in hospital due to a Covid 19 disease. He suffered from a sore throat, cough and fever, and mild pneumonia. After his breathing returned to normal, he was released. However, he continued to suffer from insomnia and anxiety symptoms, according to the report. Several weeks later, the unusual symptoms set in in the anal area. Symptoms that the man described as a restless feeling and that were associated with the irrepressible urge to move the bowel. Going to the toilet did not give him any relief.
Diagnose:Restless-Anal-Syndrom
After the doctors had carried out a series of tests, could not find any abnormalities and other possible causes such as diabetes and iron deficiency anemia could be ruled out, the doctors at the University Hospital in Tokyo are certain: the man suffers from restless anal syndrome, a variant of the Restless Legs Syndrome (RLS). The case has now been made public in “BMC Infectious Diseases”.
RLS is a neurological, sensorimotor disorder that causes those affected to feel an excruciating need to move. The symptoms can be accompanied by effects such as tingling and pain and typically occur primarily during periods of rest and in the evening. Exercise alleviates symptoms. The complaints of the 77-year-old coincided with these characteristics. He was then treated with the drug clonazepam, which is used for seizures. The symptoms improved.
A variant of the restless legs syndrome
What exactly causes RLS is not yet known. A genetic predisposition, an altered iron metabolism or an imbalance of the neurotransmitter dopamine in the brain may play a role. According to the German Restless Legs Association, 7 to 10 percent of the population is affected by RLS. RLS is one of the most common neurological diseases in western industrialized countries and is about as common as migraines. The disease occurs regardless of age.
People with RLS mainly complain of leg discomfort, but other parts of the body can also be affected. Variants of the Restless Legs Syndrome have already been observed in the abdomen and mouth, among other things. The Japanese case report is now the first anal form of the disease to be described in the medical literature. Since the symptoms appeared for the first time after the Covid 19 disease, the doctors consider a connection to be likely. Since there is currently a single case report, the causal relationship remains unclear.
It is known that Covid 19 disease can be accompanied by neurological symptoms. The most common are chronic fatigue syndrome, memory problems and difficulty concentrating. According to the German Society for Neurology, so-called encephalopathies, disorders of consciousness and disorders of brain functions also occur, especially in severe cases. Life-threatening neurological complications such as strokes or Guillain-Barré syndrome can also occur during or immediately after a Covid 19 disease. RLS cases in connection with Covid-19 have so far only been reported sporadically. The medics mention two other known cases.
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