新冠疫苗接种后急性和慢性脱髓鞘性神经病：4例报告

Acute and Chronic Demyelinating Neuropathies After COVID-19 Vaccination: A Report of 4 Cases.

作者信息

Dennis Erin, Hartman Elizabeth, Cortes-Penfield Nicolas, Piccione Ezequiel, Thaisetthawatkul Pariwat

机构信息

Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE; and.

Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE.

出版信息

J Clin Neuromuscul Dis. 2023 Mar 1;24(3):147-156. doi: 10.1097/CND.0000000000000418.

DOI:10.1097/CND.0000000000000418

PMID:36809202

Abstract

OBJECTIVES

To report demyelinating neuropathies after COVID-19 vaccination.

METHODS

Case report.

RESULTS

Four cases of demyelinating neuropathies after COVID-19 vaccination were identified at the University of Nebraska Medical Center from May to September 2021. Three were male and 1 was a female, ages 26-64 years. Three cases received Pfizer-BioNTech vaccine and 1 Johnson & Johnson. Symptom onset ranged from 2 to 21 days after vaccination. Two cases had progressive limb weakness, 3 had facial diplegia, and all had sensory symptoms and areflexia. The diagnosis was acute inflammatory demyelinating polyneuropathy in 1 case and chronic inflammatory demyelinating polyradiculoneuropathy in 3. All cases received treatment with intravenous immunoglobulin, with significant improvement in 3 of 4 who had a long-term outpatient follow-up.

CONCLUSIONS

Continued identification and reporting of cases of demyelinating neuropathies after COVID-19 vaccination is essential to determine whether a causative association is present.

摘要

目的

报告新冠病毒疫苗接种后的脱髓鞘性神经病。

方法

病例报告。

结果

2021年5月至9月期间，内布拉斯加大学医学中心确诊4例新冠病毒疫苗接种后的脱髓鞘性神经病。3例为男性，1例为女性，年龄在26至64岁之间。3例接种了辉瑞 - 生物科技公司的疫苗，1例接种了强生公司的疫苗。症状在接种疫苗后2至21天出现。2例出现进行性肢体无力，3例出现面瘫，所有患者均有感觉症状和腱反射消失。诊断为1例急性炎症性脱髓鞘性多发性神经病和3例慢性炎症性脱髓鞘性多发性神经根神经病。所有病例均接受了静脉注射免疫球蛋白治疗，4例中有3例在长期门诊随访中有显著改善。