Rao Shiavax J, Khurana Sahiba, Murthy Gayathri, Dawson Elliot T, Jazebi Noushin, Haas Christopher J
Department of Medicine, MedStar Union Memorial Hospital, Baltimore, MD, USA.
Department of Medicine, MedStar Harbor Hospital, Baltimore, MD, USA.
J Community Hosp Intern Med Perspect. 2021 Sep 20;11(5):597-600. doi: 10.1080/20009666.2021.1954284. eCollection 2021.
Since the first-reported case of Severe Acute Respiratory Distress Syndrome-Coronavirus 2 in December 2019, COVID-19 has caused a global pandemic associated with significant morbidity and mortality. After a year of advances in vaccine research and development, three vaccines for the prevention of COVID-19 (manufactured by Pfizer, Moderna and Johnson & Johnson's Janssen Biotech) are approved for use in the USA. We report the first case of Guillain-Barre Syndrome after receiving the second dose of the Pfizer COVID-19 vaccine, in a 42-year-old woman presenting with progressive ascending weakness and paresthesias. Diagnostic workup demonstrated cytoalbuminologic dissociation on cerebrospinal fluid analysis with confirmatory evidence of early demyelinating electrodiagnostic features on nerve conduction study and an extensive serological workup being negative for other viral or autoimmune disease triggers. Management included administration of intravenous immunoglobulin (total of 2 gm/kg), with frequent monitoring of forced vital capacity and negative inspiratory force. A longitudinal risk profile of neurologic complications caused from COVID-19 vaccines remains limited, and prompt recognition of potential neurological complications from the COVID-19 vaccine is of interest to public health.
自2019年12月首次报告严重急性呼吸综合征冠状病毒2型病例以来,新型冠状病毒肺炎已引发一场全球大流行,造成了严重的发病率和死亡率。经过一年的疫苗研发进展,三种预防新型冠状病毒肺炎的疫苗(由辉瑞、莫德纳和强生公司的杨森生物技术公司生产)已在美国获批使用。我们报告了首例在接种辉瑞新型冠状病毒肺炎疫苗第二剂后发生吉兰-巴雷综合征的病例,患者为一名42岁女性,表现为进行性上行性肌无力和感觉异常。诊断检查显示脑脊液分析存在蛋白细胞分离,神经传导研究有早期脱髓鞘电诊断特征的确诊证据,广泛的血清学检查对其他病毒或自身免疫性疾病触发因素呈阴性。治疗包括静脉注射免疫球蛋白(总量2克/千克),并频繁监测用力肺活量和吸气负压。新型冠状病毒肺炎疫苗引起的神经系统并发症的纵向风险情况仍然有限,及时识别新型冠状病毒肺炎疫苗潜在的神经系统并发症受到公共卫生领域的关注。