Dados do Trabalho

Título

Post Covid-19 vaccine-associated acute myeloradiculoneuropathy responsive to plasmapheresis

RESUMO

A 31-year-old male patient presented with acute tetraparesis and urinary retention one day after the first dose of the Covid-19 vaccine. Covid-19 PCR (polymerase chain reaction) was negative, and IgM (Immunoglobulin M) Covid-19 was reactive. Electromyography showed asymmetric motor-sensory axonal polyneuropathy. Cervical MRI (Magnetic resonance imaging) revealed a longitudinally extensive cervical transverse myelitis (figure 1). Immunoglobulin for five days improved arms strength. Methylprednisolone for five days was started without improvement. He also underwent plasmapheresis with improvement. Blood tests and cerebrospinal fluid were performed, excluding autoimmune diseases, other infections, and neuromyelitis optica (Table 1). He returned walking unassisted after 60 days with mild hypoesthesia in his left foot and mild urinary retention. Previous reports with similar and worse outcomes were reported after the Covid-19 vaccine, after Covid-19, and other viral infections1,2. Our report presents one of the earliest cases described after vaccination; however, it has already been registered at a similar time3. Such cases usually occur with extended latency periods, probably by SARS-CoV-2 antigens in the Covid-19 vaccine or its chimpanzee adenovirus adjuvant. These antigens could cause myelitis by immune mechanisms2.

Palavras Chave

COVID-19, MYELITIS