Department of Neurology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea.
Department of Neurology, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine, Sejong, Korea.
J Korean Med Sci. 2023 Feb 27;38(8):e57. doi: 10.3346/jkms.2023.38.e57.
The occurrence of chronic inflammatory demyelinating polyneuropathy (CIDP) related to coronavirus disease 2019 (COVID-19) has rarely been reported. We describe two patients who were diagnosed with CIDP after COVID-19 vaccination. A 72-year-old man presented with a progressive tingling sensation and weakness below both knees for two weeks. He had been vaccinated against COVID-19 (mRNA-1273 vaccine) a month before the appearance of symptoms. Demyelinating polyneuropathy was observed in the nerve conduction studies (NCS). Intravenous immunoglobulin (IVIg) was administered under the diagnosis of Guillain-Barré syndrome (GBS), and his symptoms were improved. However, his symptoms relapsed at 10 weeks from the onset. Oral prednisolone, azathioprine, and IVIg were administered as treatment. The second case was a 50-year-old man who complained of a bilateral leg tingling sensation and gait disturbance lasting four weeks. He had received the Ad26.COV2.S vaccine against COVID-19 five weeks prior. Demyelinating polyneuropathy was observed in the NCS. He was treated with oral prednisolone, azathioprine, and IVIg for CIDP because his symptoms had lasted for more than 12 weeks from the onset. A causal relationship has not been established between COVID-19 vaccination and CIDP; however, CIDP may follow COVID-19 vaccination. As CIDP treatment is different from that for GBS, clinicians should closely monitor patients diagnosed with GBS associated with COVID-19 whether they deteriorate after initial treatment.
慢性炎症性脱髓鞘性多发性神经病（CIDP）与 2019 年冠状病毒病（COVID-19）相关的发生很少有报道。我们描述了两例 COVID-19 疫苗接种后诊断为 CIDP 的患者。一名 72 岁男性，双膝关节以下进行性刺痛和无力两周。他在症状出现前一个月接种了 COVID-19（mRNA-1273 疫苗）。神经传导研究（NCS）观察到脱髓鞘性多发性神经病。根据格林-巴利综合征（GBS）的诊断给予静脉注射免疫球蛋白（IVIg），他的症状有所改善。然而，他的症状在发病后 10 周复发。给予口服泼尼松、硫唑嘌呤和 IVIg 治疗。第二例是一名 50 岁男性，诉双下肢刺痛和步态障碍持续四周。他在五周前接种了 Ad26.COV2.S 疫苗以预防 COVID-19。NCS 观察到脱髓鞘性多发性神经病。由于他的症状从发病开始已经持续了 12 周以上，他被诊断为 CIDP，并接受了口服泼尼松、硫唑嘌呤和 IVIg 治疗。尚未确定 COVID-19 疫苗接种与 CIDP 之间存在因果关系；然而，CIDP 可能在 COVID-19 疫苗接种后发生。由于 CIDP 的治疗与 GBS 不同，临床医生应密切监测与 COVID-19 相关的 GBS 患者，无论他们在初始治疗后是否恶化。
