辉瑞-生物科技新冠疫苗引起的新发眼肌型重症肌无力的临床病程。

The Clinical Course of New-Onset Ocular Myasthenia Gravis Caused by Pfizer-BioNTech COVID-19 Vaccine.

机构信息

Department of Neurology, En Chu Kong Hospital, New Taipei City 237, Taiwan; Department of Neurology, National Taiwan University Hospital, Taipei 100, Taiwan.

Department of Neurology, En Chu Kong Hospital, New Taipei City 237, Taiwan.

出版信息

Acta Neurol Taiwan. 2023 Dec 30;32(4):218-222.

PMID:37723915

Abstract

PURPOSE

Myasthenia gravis (MG) caused by COVID-19 vaccine had been reported, but the clinical course of new-onset ocular MG had never been described. We would like to document the clinical course of a patient with new-onset ocular MG which was caused by Pfizer-BioNTech COVID-19 vaccine.

CASE REPORT

A 39-year-old woman noticed diplopia one week after she accepted the first dose of Pfizer- BioNTech COVID-19 vaccine. Diagnosis of ocular MG was made after investigation. Despite intravenous immunoglobulins, pyridostigmine and prednisolone therapy, she had no improvement until 10 days after treatment. She then rapidly improved, and almost fully recovered in the following 10 days. We had observed this patient for 8 months. After tapering off steroid, she remained stable to date, though she still suffered from transient diplopia on awakening.

CONCLUSION

No matter the symptoms at onset, the clinical course or the response to steroid therapy was identical to ocular MG that we had ever known. Ocular MG caused by COVID-19 vaccine could probably be an iatrogenic life-long disease.

摘要

目的

有报道称 COVID-19 疫苗可引起重症肌无力（MG），但从未描述过新发性眼肌型 MG 的临床过程。我们希望记录由辉瑞- BioNTech COVID-19 疫苗引起的新发眼肌型 MG 患者的临床过程。

病例报告

一名 39 岁女性在接受第一剂辉瑞- BioNTech COVID-19 疫苗后一周出现复视。经过检查，诊断为眼肌型 MG。尽管接受了静脉注射免疫球蛋白、吡啶斯的明和泼尼松龙治疗，但在治疗 10 天后仍未见改善。然后她迅速好转，在接下来的 10 天内几乎完全恢复。我们对该患者进行了 8 个月的观察。在逐渐减少类固醇剂量后，她至今仍然稳定，尽管她在醒来时仍会出现短暂性复视。