由 COVID-19 mRNA 引发的多发性硬化症和视神经炎

Giovanna Thais Torques Moretti , Giorgio Fabiani , Georgette Mouchaileh Evangelista Ferreira , Jessica Pizatto de Araujo , Eduardo Hummelgen
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摘要

背景2019年12月,世界卫生组织宣布COVID-19为大流行病;一场前所未有的健康危机震撼了世界。为控制 COVID-19 大流行,各国政府、制药业和卫生专业人员付出了巨大努力,其中包括针对 SARS-CoV-2 的新型 mRNA 疫苗技术。该疫苗的主要机制是基于 S 糖蛋白(主要的病毒表面抗原),它能诱导保护性中和抗体。第一个病例是一名年轻女性,25 岁,之前无症状,接种 ChAdOx1 疫苗一周后出现右侧偏瘫。脑部核磁共振成像和脊髓核磁共振成像显示多处急性和慢性高强度病变。第二个病例是一名 8 岁的白种男性;在接种两剂辉瑞生物技术疫苗 12 天后,患者主诉双侧视力模糊。结论疫苗很少会引发多发性硬化或视神经炎。本报告展示了 m-RNA COVID-19 疫苗引发的两种脱髓鞘综合征。
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Multiple sclerosis and optic neuritis triggered by COVID-19 mRNA

Background

In December 2019, the World Health Organization declared COVID-19 a pandemic; an unprecedented health crisis has rocked the world. Enormous efforts by governments, the pharmaceutical industry, and health professionals, including a new mRNA vaccine technology against SARS-CoV-2, have been massively employed to control the COVID-19 pandemic. The vaccine's primary mechanism is based on S glycoprotein, the leading viral surface antigen, which induces protective neutralizing antibodies.

Case presentation

This project aims to present two cases of demyelinating syndromes in previously asymptomatic patients. The triggering factor in both cases was vaccination against COVID-19 with mRNA vaccines.

Case Report

The first case is a young female, 25 years old, previously asymptomatic, one week after the ChAdOx1 Vaccine developed right hemiparesis. Brain MRI and MRI of the spinal cord demonstrated multiple hyperintense lesions, acute and chronic. The second case is an 8-year-old Caucasian male; 12 days after the double dose of the Pfizer-BioNTech vaccine, the patient complained of bilateral visual blurring. The patient was pulsed with methylprednisolone one g/day/5 days with complete recovery.

Conclusion

Rarely can vaccines trigger multiple sclerosis or optic neuritis. This report demonstrated two demyelinating syndromes triggered by the m-RNA COVID-19 vaccine.

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