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Severe disease exacerbation after mRNA COVID-19 vaccination unmasks suspected multiple sclerosis as neuromyelitis optica spectrum disorder: a case report.
Lohmann, Lisa; Glaser, Felix; Möddel, Gabriel; Lünemann, Jan D; Wiendl, Heinz; Klotz, Luisa.
  • Lohmann L; Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany. Lisa.Lohmann@ukmuenster.de.
  • Glaser F; Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
  • Möddel G; Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
  • Lünemann JD; Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
  • Wiendl H; Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
  • Klotz L; Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
BMC Neurol ; 22(1): 185, 2022 May 18.
Article in English | MEDLINE | ID: covidwho-1951107
ABSTRACT

BACKGROUND:

Since the beginning of the COVID-19 pandemic and development of new vaccines, the issue of post-vaccination exacerbation or manifestation of demyelinating central nervous system (CNS) disorders has gained increasing attention. CASE PRESENTATION We present a case of a 68-year-old woman previously diagnosed with multiple sclerosis (MS) since the 1980s who suffered a rapidly progressive severe sensorimotor paraparesis with loss of bladder and bowel control due to an acute longitudinal extensive transverse myelitis (LETM) after immunization with the mRNA Pfizer-BioNTech COVID-19 vaccine. Detection of Aquaporin-4-antibodies (AQP4) in both serum and CSF led to diagnosis of AQP4-antibody positive neuromyelitis optica spectrum disorder (NMOSD). Treatment with intravenous corticosteroids and plasmapheresis led to a slight improvement of the patient's symptoms.

CONCLUSIONS:

Pathogenic mechanisms of post-vaccination occurrence of NMOSD are still unknown. However, cases like this should make aware of rare neurological disorders manifesting after vaccination and potentially contribute to improvement of management of vaccinating patients with inflammatory CNS disorders in the future. So far two cases of AQP4-antibody positive NMOSD have been reported in association with viral vector COVID-19 vaccines. To our knowledge, we report the first case of AQP4-antibody positive NMOSD after immunization with an mRNA COVID-19-vaccine.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Neuromyelitis Optica / COVID-19 / BNT162 Vaccine / Multiple Sclerosis / Myelitis, Transverse Type of study: Case report / Diagnostic study / Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Aged / Female / Humans Language: English Journal: BMC Neurol Journal subject: Neurology Year: 2022 Document Type: Article Affiliation country: S12883-022-02698-y

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Neuromyelitis Optica / COVID-19 / BNT162 Vaccine / Multiple Sclerosis / Myelitis, Transverse Type of study: Case report / Diagnostic study / Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Aged / Female / Humans Language: English Journal: BMC Neurol Journal subject: Neurology Year: 2022 Document Type: Article Affiliation country: S12883-022-02698-y