Thalamic hemi-chorea: a rare complication after receiving the adenoviral vector-based COVID-19 vaccine: a case report.

Hamze Shahali, Ramin Hamidi Farahani, Ali Asgari, Ebrahim Hazrati
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引用次数: 4

Abstract

Lacunar strokes occur when a branch of a large cerebral artery is blocked. The thalamus is often affected, causing uncontrollable motions. A 72-year-old previously healthy man presented with involuntary motions in the right limbs, which were present at rest, and exacerbated during voluntary actions. He had received the first dose of the adenoviral vector-based coronavirus disease 2019 vaccine (ChAdOx1 nCoV-19) 9 days ago. Severe thrombocytopenia and elevated levels of lactate dehydrogenase, ferritin, C-reactive protein, and D-dimer were found, without any evidence of connective tissue disease. Electromyography demonstrated typical choreiform movements, and the brain magnetic resonance imaging indicated a small high signal lesion on the left side of the thalamus. Detection of the immunoglobulin G antibodies against platelet factor 4 in the blood, negative heparin-induced platelet activation (HIPA) test, and positive modified HIPA test confirmed the thalamic stroke due to the vaccine-induced prothrombotic immune thrombocytopenia (VIPIT). He was admitted to the intensive care unit and received nadroparin, sodium ozagrel, edaravone, methylprednisolone, and haloperidol. His hemi-chorea improved gradually over 2 weeks, and he was discharged after 21 days with rehabilitation advice. VIPIT due to the ChAdOx1 nCoV-19 is a novel immune-mediated response that needs clinicians' awareness and further investigations.

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丘脑半舞蹈病:接种基于腺病毒载体的COVID-19疫苗后的罕见并发症:1例报告
脑腔隙性中风发生在大脑大动脉的一个分支被阻塞的时候。丘脑经常受到影响,导致无法控制的运动。一名72岁以前健康的男性,在休息时出现右肢体不自主运动,并在自主活动时加重。9天前,他接种了第一剂基于腺病毒载体的2019冠状病毒病疫苗(ChAdOx1 nCoV-19)。发现严重的血小板减少症和乳酸脱氢酶、铁蛋白、c反应蛋白和d -二聚体水平升高,无结缔组织疾病的证据。肌电图显示典型的舞蹈样运动,脑磁共振成像显示丘脑左侧有一个小的高信号病变。血液中抗血小板因子4的免疫球蛋白G抗体检测、肝素诱导血小板活化(HIPA)试验阴性、改良HIPA试验阳性均证实疫苗诱导的血栓性免疫性血小板减少症(VIPIT)所致丘脑卒中。他被送进重症监护室,接受了nadroparin、ozagrel钠、依达拉奉、甲基强的松龙和氟哌啶醇。他的半舞蹈症在2周内逐渐改善,并在康复建议下于21天后出院。由ChAdOx1 nCoV-19引起的VIPIT是一种新的免疫介导反应,需要临床医生的认识和进一步的研究。
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来源期刊
CiteScore
3.70
自引率
3.70%
发文量
29
审稿时长
8 weeks
期刊介绍: Clin Exp Vaccine Res, the official English journal of the Korean Vaccine Society, is an international, peer reviewed, and open-access journal. It covers all areas related to vaccines and vaccination. Clin Exp Vaccine Res publishes editorials, review articles, special articles, original articles, case reports, brief communications, and correspondences covering a wide range of clinical and experimental subjects including vaccines and vaccination for human and animals against infectious diseases caused by viruses, bacteria, parasites and tumor. The scope of the journal is to disseminate information that may contribute to elaborate vaccine development and vaccination strategies targeting infectious diseases and tumors in human and animals. Relevant topics range from experimental approaches to (pre)clinical trials for the vaccine research based on, but not limited to, basic laboratory, translational, and (pre)clinical investigations, epidemiology of infectious diseases and progression of all aspects in the health related issues. It is published printed and open accessed online issues (https://ecevr.org) two times per year in 31 January and 31 July. Clin Exp Vaccine Res is linked to many international databases and is made freely available to institutions and individuals worldwide
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