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Acute autoimmune transverse myelitis following COVID-19 vaccination: A case report

RATIONALE: Transverse myelitis is an infectious or noninfectious inflammatory spinal cord syndrome. We report a rare case of transverse myelitis following vaccination against COVID-19. PATIENT CONCERNS: A 70-year-old male presented with progressive sensorimotor dysfunction of the bilateral lower lim...

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Autores principales: Hirose, Satoshi, Hara, Makoto, Koda, Kento, Natori, Naotoshi, Yokota, Yuki, Ninomiya, Satoko, Nakajima, Hideto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8701778/
https://www.ncbi.nlm.nih.gov/pubmed/34941191
http://dx.doi.org/10.1097/MD.0000000000028423
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author Hirose, Satoshi
Hara, Makoto
Koda, Kento
Natori, Naotoshi
Yokota, Yuki
Ninomiya, Satoko
Nakajima, Hideto
author_facet Hirose, Satoshi
Hara, Makoto
Koda, Kento
Natori, Naotoshi
Yokota, Yuki
Ninomiya, Satoko
Nakajima, Hideto
author_sort Hirose, Satoshi
collection PubMed
description RATIONALE: Transverse myelitis is an infectious or noninfectious inflammatory spinal cord syndrome. We report a rare case of transverse myelitis following vaccination against COVID-19. PATIENT CONCERNS: A 70-year-old male presented with progressive sensorimotor dysfunction of the bilateral lower limbs 7 days after receiving the mRNA-1273 vaccine against COVID-19. Spinal magnetic resonance imaging revealed intramedullary lesions with gadolinium enhancement on the Th1/2 and Th5/6 vertebral levels. Cerebrospinal fluid (CSF) testing showed a mildly increased level of total protein and positive oligoclonal bands (OCB). DIAGNOSIS: The patient was diagnosed with acute transverse myelitis. INTERVENTION: The patient received 5 days of intravenous methylprednisolone pulse (1000 mg/day) followed by oral prednisolone (30 mg/day with gradual tapering). OUTCOMES: The patient fully recovered from muscle weakness of the lower limbs. He was discharged from our hospital and able to independently walk without unsteadiness. LESSON: This is a rare case of transverse myelitis following COVID-19 vaccination. Positive OCB in CSF in the present case highlights the possibility of autoimmune processes, including polyclonal activation of B lymphocytes, following vaccination.
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spelling pubmed-87017782021-12-27 Acute autoimmune transverse myelitis following COVID-19 vaccination: A case report Hirose, Satoshi Hara, Makoto Koda, Kento Natori, Naotoshi Yokota, Yuki Ninomiya, Satoko Nakajima, Hideto Medicine (Baltimore) 5300 RATIONALE: Transverse myelitis is an infectious or noninfectious inflammatory spinal cord syndrome. We report a rare case of transverse myelitis following vaccination against COVID-19. PATIENT CONCERNS: A 70-year-old male presented with progressive sensorimotor dysfunction of the bilateral lower limbs 7 days after receiving the mRNA-1273 vaccine against COVID-19. Spinal magnetic resonance imaging revealed intramedullary lesions with gadolinium enhancement on the Th1/2 and Th5/6 vertebral levels. Cerebrospinal fluid (CSF) testing showed a mildly increased level of total protein and positive oligoclonal bands (OCB). DIAGNOSIS: The patient was diagnosed with acute transverse myelitis. INTERVENTION: The patient received 5 days of intravenous methylprednisolone pulse (1000 mg/day) followed by oral prednisolone (30 mg/day with gradual tapering). OUTCOMES: The patient fully recovered from muscle weakness of the lower limbs. He was discharged from our hospital and able to independently walk without unsteadiness. LESSON: This is a rare case of transverse myelitis following COVID-19 vaccination. Positive OCB in CSF in the present case highlights the possibility of autoimmune processes, including polyclonal activation of B lymphocytes, following vaccination. Lippincott Williams & Wilkins 2021-12-23 /pmc/articles/PMC8701778/ /pubmed/34941191 http://dx.doi.org/10.1097/MD.0000000000028423 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/)
spellingShingle 5300
Hirose, Satoshi
Hara, Makoto
Koda, Kento
Natori, Naotoshi
Yokota, Yuki
Ninomiya, Satoko
Nakajima, Hideto
Acute autoimmune transverse myelitis following COVID-19 vaccination: A case report
title Acute autoimmune transverse myelitis following COVID-19 vaccination: A case report
title_full Acute autoimmune transverse myelitis following COVID-19 vaccination: A case report
title_fullStr Acute autoimmune transverse myelitis following COVID-19 vaccination: A case report
title_full_unstemmed Acute autoimmune transverse myelitis following COVID-19 vaccination: A case report
title_short Acute autoimmune transverse myelitis following COVID-19 vaccination: A case report
title_sort acute autoimmune transverse myelitis following covid-19 vaccination: a case report
topic 5300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8701778/
https://www.ncbi.nlm.nih.gov/pubmed/34941191
http://dx.doi.org/10.1097/MD.0000000000028423
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