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Título

PIDC case after vaccination for Covid-19 in a patient followed up at Hospital Universitário Getúlio Vargas and Ambulatório Araújo Lima

RESUMO

Vaccines against COVID-19 have mainly been associated with adverse events of little clinical importance. The profile of these side effects is still undetermined and more serious adverse events have been reported in a minority of cases. One such event is immune-mediated inflammatory polyneuropathy. There are some reports in the literature of cases of acute-onset inflammatory polyradiculoneuropathy in patients after COVID-19 infection and vaccination. Although little described in the literature, CIDP has already been reported in the post-vaccination period for influenza, tetanus and other common vaccines. We describe the case of a 52-year-old patient, who performed the first dose of vaccination for Covid-19 (Astrazeneca) on 06/12/2021 and, on June 16, 2021, started tingling in his hands and feet. The following day, he developed weakness in the lower limbs and, one day later, he was no longer able to walk. He was taken to the emergency room, submitted to hospital admission on the third day of illness; during this hospitalization, therapy with human immunoglobulin (1.65 mg/kg dose) was performed, with partial improvement of symptoms. After three weeks of hospital discharge, he developed dysphagia and respiratory distress, being hospitalized again in the emergency room on 08/03/2021. He was transferred to HUGV for follow-up with Neurology on 08/07/2021. On 08/13/2021, an electroneuromyography of the four limbs was performed, which showed sensory and motor neuropathy, axonal, symmetrical, with denervation of very serious intensity and intense signs of activity. During this hospitalization, he performed seven sessions of plasmapheresis, observing significant clinical improvement. Two weeks after hospital discharge, the weakness worsened, initially in the upper limbs and later in the lower limbs, and he was hospitalized again on 10/14/2021 for clinical compensation, when immunoglobulin therapy was performed at a dose of 2 g/kg and this therapy was maintained. monthly for six months, with significant improvement. Due to the clinical characteristics, ruling out other diagnoses and the form of disease progression, the diagnostic hypothesis of CIDP was proposed. In view of the above, it can be seen that there is temporality between vaccination and the onset of symptoms presented by the patient. The adverse effects of vaccines for Covid-19 are still being known, so it is essential to publish this report as a form of contribution to the scientific community.

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Área

Neuropatias Periféricas