一种替代性冠状病毒病2019疫苗引发的伴有复视的慢性炎症性脱髓鞘多发性神经病

IF 0.9 Q4 CLINICAL NEUROLOGY Case Reports in Neurological Medicine Pub Date : 2024-06-11 eCollection Date: 2024-01-01 DOI:10.1155/2024/8584482
Satoshi Saito, Mutsumi Iijima, Misa Seki, Ayato Shimomura, Kazuo Kitagawa
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引用次数: 0

摘要

慢性炎症性脱髓鞘多发性神经病(CIDP)的病因仍然难以捉摸,据信涉及多种诱因。有病例表明,CIDP 与冠状病毒病 2019(COVID-19)mRNA 疫苗有关。然而,目前还没有接种其他疫苗的病例记录。我们报告了一例 48 岁女性的病例,她之前接种了辉瑞生物技术公司的 COVID-19 疫苗 (BNT162b2),之后又接种了 Moderna mRNA-1273 疫苗。接种后 2 天内,她出现了复视和下肢远端麻木。脑脊液分析显示蛋白细胞离解,F 波研究显示双侧胫神经有脱髓鞘活动。考虑到疾病的进行性,患者被推测为患有脊髓灰质炎,并开始接受类固醇脉冲治疗和静脉注射免疫球蛋白治疗。CIDP 的发病可能与 mRNA 序列和疫苗成分的变化有关。
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Chronic Inflammatory Demyelinating Polyradiculoneuropathy with Diplopia Caused by an Alternative Coronavirus Disease 2019 Vaccine.

The etiology of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) remains elusive and is believed to involve multiple contributing factors. There have been cases linking CIDP to the coronavirus disease 2019 (COVID-19) mRNA vaccine. However, there are no documented instances following alternative vaccines. We report a case of a 48-year-old woman, previously vaccinated with Pfizer-BioNTech's COVID-19 vaccine (BNT162b2), who subsequently received the Moderna mRNA-1273 vaccine. Within 2 days postvaccination, she developed diplopia and numbness in the lower limbs' distal extremities. Cerebrospinal fluid analysis exhibited protein-cell dissociation, while F-wave studies showed demyelinating activity in the bilateral tibial nerves. Given the disease's progressive nature, the patient was presumed to have CIDP and commenced steroid pulse therapy and intravenous immunoglobulin therapy. The onset of CIDP may be associated with variations in mRNA sequences and vaccine constituents.

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