Institute of Clinical Neuroimmunology, Ludwig-Maximilians University Munich, Munich, Germany; Department of Neurology, University Hospital Munich, Ludwig-Maximilians University Munich, Munich, Germany.
Institute of Neuroradiology, LMU Hospital, Ludwig-Maximilians University Munich, Munich, Germany.
Mult Scler Relat Disord. 2022 Nov;67:104175. doi: 10.1016/j.msard.2022.104175. Epub 2022 Sep 11.
Clinical onset of multiple sclerosis (MS) and myelin-oligodendrocyte-glycoprotein-antibody-associated disease (MOGAD) has been reported in association with SARS-CoV-2-vaccination. There is uncertainty as to whether this is causality (denovo disease) or temporal coincidence (manifestation of a preexisting, subclinical neuroinflammation).
Comparing the clinical characteristics of MS-patients versus patients with MS (PwMS) whose clinical onset occurred independently of vaccination (MS).
Consecutive patients with clinical onset ≤30 days after SARS-CoV-2-vaccination were included. Clinical data, cerebrospinal fluid (CSF) parameters and magnetic resonance imaging (MRI) as well as optical coherence tomography (OCT) data were compared to an age- and sex-matched MS-cohort.
We identified 5 MS and 1 MOGAD patients who developed their clinical onset ≤ 30 days after SARS-CoV-2-vaccination. Clinical characteristics, CSF, MRI and OCT parameters from MS patients were comparable to the MS cohort and showed evidence of preexisting subclinical CNS disease. The single case with MOGAD clearly differed from PwMS in higher CSF cell counts, remission of MRI lesions during follow-up, and absence of oligoclonal bands.
Our case series indicates that MS patients showed a rather typical initial manifestation in temporal association with SARS-CoV-2-vaccination and harbored preexisting subclinical neuroinflammation. This argues against the denovo development of MS in this cohort.
据报道，新冠病毒疫苗接种后会出现多发性硬化症（MS）和髓鞘少突胶质细胞糖蛋白抗体相关疾病（MOGAD）的临床发病。目前尚不确定这是因果关系（新发病）还是时间巧合（潜在的亚临床神经炎症表现）。
比较 MS 患者与独立于疫苗接种（MS）发生临床发病的 MS 患者（PwMS）的临床特征。
连续纳入接种新冠病毒疫苗后临床发病≤30 天的患者。比较临床数据、脑脊液（CSF）参数、磁共振成像（MRI）以及光学相干断层扫描（OCT）数据与年龄和性别匹配的 MS 队列。
我们发现 5 例 MS 和 1 例 MOGAD 患者在接种新冠病毒疫苗后≤30 天内出现临床发病。MS 患者的临床特征、CSF、MRI 和 OCT 参数与 MS 队列相似，表明存在潜在的亚临床中枢神经系统疾病。MOGAD 的单一病例与 PwMS 的差异在于更高的 CSF 细胞计数、随访期间 MRI 病变的缓解以及缺乏寡克隆带。
我们的病例系列表明，MS 患者在与新冠病毒疫苗接种时间相关的情况下表现出相当典型的初始表现，且存在潜在的亚临床神经炎症。这表明该队列中不存在 MS 的新发病。
