Vences Miguel A, Canales Diego, Albujar Maria Fe, Barja Ebelin, Araujo-Chumacero Mary M, Cardenas Edu, Alvarez Arturo, Urrunaga-Pastor Diego
Departamento de Neurología, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima 15072, Peru.
Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola (USIL), Lima 15012, Peru.
Vaccines (Basel). 2022 Jul 1;10(7):1065. doi: 10.3390/vaccines10071065.
We describe the case of a 72-year-old man who received the first dose of the BNT162b2 (COMIRNATY) vaccine against COVID-19 on 18 May 2021, and the second dose on 9 September 2021. One day after receiving the first dose, he cursed with malaise, headache, fever, confusion, aggressiveness, and gait alterations. We performed serum and cerebrospinal fluid (CSF) tests (finding elevated proteins in CSF) with negative results for infectious, systemic, and neoplastic causes. We performed brain nuclear magnetic resonance imaging (MRI), finding circumscribed encephalitis at the anterior frontal and bilateral temporal lobes. We were unable to perform a panel of antineuronal antibodies. The patient was readmitted due to early clinical relapse four days after receiving his second dose. We found sequelae lesions at the frontal level but with new demyelinating lesions at the left temporal level in brain MRI. We indicated methylprednisolone, and he presented a favorable improvement. We report an encephalitis case of probable autoimmune etiology after vaccination with BNT162b2, which presented early clinical relapse after receiving the second dose and presented a favorable response to methylprednisolone.
我们描述了一名72岁男性的病例，他于2021年5月18日接种了第一剂BNT162b2（科兴疫苗）新冠疫苗，并于2021年9月9日接种了第二剂。接种第一剂疫苗一天后，他出现不适、头痛、发热、意识模糊、攻击性和步态改变。我们进行了血清和脑脊液（CSF）检测（发现脑脊液中蛋白质升高），结果显示感染、全身性和肿瘤性病因均为阴性。我们进行了脑部核磁共振成像（MRI），发现前额叶和双侧颞叶有局限性脑炎。我们无法进行一组抗神经元抗体检测。患者在接种第二剂疫苗四天后因早期临床复发再次入院。我们在脑部MRI中发现额叶有后遗症病变，但左侧颞叶有新的脱髓鞘病变。我们给予甲基强的松龙治疗，他的病情有了良好改善。我们报告了一例接种BNT162b2疫苗后可能由自身免疫病因引起的脑炎病例，该病例在接种第二剂疫苗后出现早期临床复发，并对甲基强的松龙治疗反应良好。
