Acharya Bimarsh, Kc Sabin, Karki Shailendra, Thapa Pratima, Kc Pooja
KIST Medical College and Teaching Hospital, Lalitpur, Gwarko.
Gandaki Medical College, Pokhara.
Ann Med Surg (Lond). 2023 Feb 17;85(3):466-469. doi: 10.1097/MS9.0000000000000193. eCollection 2023 Mar.
Guillain-Barré syndrome (GBS) is a rare acute idiopathic demyelinating polyneuropathy that causes bilateral, symmetrical, and progressive weakness of muscles. AstraZeneca vaccine is a genetically modified spike glycoprotein vaccine of an adenovirus vector. GBS following the second dose of the AstraZeneca vaccine dose is rare and not frequently noted.
A 78-year-old male presented to the hospital with complaints of bilateral weakness of the lower limbs over 4 days following the second dose of the AstraZeneca vaccine. On examination, the power and tone of the limbs were diminished. The sensitivity pinprick test revealed low sensitivity in the right lower limb than in the left lower limb. Nerve conduction studies revealed acute inflammatory demyelinating polyneuropathy and the patient was diagnosed with GBS. After admission, the patient was successfully treated with intravenous immunoglobulins along with physiotherapy.
GBS can be diagnosed clinically with nerve conduction studies and Brighton's criteria. The robust causal relationships between COVID-19 infections, COVID-19 vaccination, and GBS are still unclear. The evaluation of the potential association and risk of GBS with vaccines warrants the need for precise post-vaccination surveillance measures and results.
Only a few cases of GBS following the second dose of AstraZeneca are reported so far and there is a need for strong and accurate diagnosis of the disease and proper post-vaccination surveillance for the evaluation of risk associated with COVID vaccines.
吉兰-巴雷综合征（GBS）是一种罕见的急性特发性脱髓鞘性多发性神经病，可导致双侧、对称性和进行性肌肉无力。阿斯利康疫苗是一种腺病毒载体的基因改造刺突糖蛋白疫苗。接种第二剂阿斯利康疫苗后发生GBS的情况罕见且不常被注意到。
一名78岁男性在接种第二剂阿斯利康疫苗4天后因双下肢无力入院。检查发现四肢肌力和肌张力减弱。针刺觉测试显示右下肢比左下肢感觉减退。神经传导研究显示为急性炎症性脱髓鞘性多发性神经病，该患者被诊断为GBS。入院后，患者通过静脉注射免疫球蛋白及物理治疗成功治愈。
GBS可通过神经传导研究和布莱顿标准进行临床诊断。新型冠状病毒肺炎感染、新型冠状病毒肺炎疫苗接种与GBS之间的明确因果关系仍不清楚。评估GBS与疫苗的潜在关联和风险需要精确的疫苗接种后监测措施及结果。
迄今为止，仅报告了少数几例接种第二剂阿斯利康疫苗后发生GBS的病例，需要对该疾病进行强有力且准确的诊断，并进行适当的疫苗接种后监测，以评估与新冠疫苗相关的风险。
