Severe Presentation of Neuromyelitis Optica with Positive Antibody Following COVID-19 Vaccination
Neurology
; 98(18 SUPPL), 2022.
Article
in English
| EMBASE | ID: covidwho-1925300
ABSTRACT
Objective:
To report a case of antibody-positive neuromyelitis optica (NMO) after COVID-19 vaccination.Background:
Neuromyelitis optica spectrum disorder is a rare demyelinating disorder of the central nervous system characterized by longitudinally extensive transverse myelitis (LETM) and severe, sometimes bilateral optic neuritis. The majority of cases have serologic or CSF antibody for aquaporin-4 (AQP4). Design/Methods:
Case reportResults:
A 19 year old woman with no prior medical history presented with two days of progressive, severe weakness and sensory changes first in the arms, then legs. On the morning of presentation, she woke with urinary incontinence. She had received COVID-19 vaccination (Moderna) fifteen days preceding her onset of symptoms. Examination revealed sinus tachycardia, MRC grade 3-4/5 power in the arms, 0/5 in the legs with approximately T4 sensory level. Cervical spine MRI revealed T2 prolongation in the spinal cord extending from the cervicomedullary junction to the conus medullaris. CSF revealed neutrophilic pleocytosis with increased IgG synthesis rate and positive CSF AQP4 antibody;serum AQP4 and MOG antibodies were negative. Bilateral, saddle pulmonary emboli were discovered shortly after admission. Her NMO was treated with high-dose intravenous methylprednisolone, plasmapheresis, and rituximab.Conclusions:
This case describes a severe, new presentation of antibody-positive neuromyelitis optica following vaccination against COVID-19.
aquaporin 4; aquaporin 4 antibody; endogenous compound; immunoglobulin G; methylprednisolone; rituximab; adult; case report; central nervous system; cerebrospinal fluid; cervical spine; clinical article; conference abstract; conus medullaris; coronavirus disease 2019; demyelinating disease; drug megadose; female; gene expression; human; human cell; human tissue; intravenous drug administration; leg; longitudinally extensive transverse myelitis; lung embolism; medical history; myelooptic neuropathy; neutrophil; nuclear magnetic resonance imaging; optic neuritis; plasmapheresis; pleocytosis; sinus tachycardia; synthesis; urine incontinence; vaccination; weakness; young adult
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Collection:
Databases of international organizations
Database:
EMBASE
Topics:
Vaccines
Language:
English
Journal:
Neurology
Year:
2022
Document Type:
Article
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