Acute encephalitis following COVID-19 vaccines: A case series
Allergy: European Journal of Allergy and Clinical Immunology
; 78(Supplement 111):309, 2023.
Article
in English
| EMBASE | ID: covidwho-2299535
ABSTRACT
Case report Background:
Neurological adverse effects (NAE) as headache and dizziness are commonly reported with COVID-19 vaccines but are transient and self-limited. However, few serious NAE have been recently described which can be fatal. Here we report two rare cases of encephalitis related to COVID-19vaccination BNT162b2 (Pfizer) and mRNA-1273 (Moderna) and the inherent challenges in their diagnosis. Method(s) We report two cases of acute encephalitis notified to the department of pharmacovigilance in the University Hospital of MonastirResults:
Case n'1 Three weeks after receiving her first dose of mRNA-1273, a 35-year- old female, with a medical history of hypothyroidism and eczema was admitted to the intensive care unit as she had confusion and a febrile tonic-clonic seizure complicated with a status epilepticus and dysautonomia. CSF investigations were nonspecific, and the MRI head did not detect any abnormality. Common causes were excluded by an extensive workup (neoplastic, neuro-vascular, autoimmune and infectious causes). She received cefotaxime and acyclovir without any recovery. However, a spectacular recovery was noticed when receiving methylprednisolone. Case n'2 Three days after receiving her first dose of BNT162b2, a-40- year- old female, with a medical history of rheumatoid arthritis was admitted to the medical care unit as she had experienced a three-day history of headache, memory disturbance, severe cognitive disorders and 4 febrile tonic-clonic seizures. MRI head showed signs of bitemporal encephalitis and CSF investigations was with no findings. Extensive laboratory studies ran out alternative causes as neoplastic, autoimmune and infectious diseases. A twenty-one- day acyclovir regimen was administrated with no recovery. As the cognitive deficit is getting more severe, she got intravenous immunoglobulin therapy with a spectacular improvement. Conclusion(s) Based on the Naranjo Algorithm, this adverse NAR can be possibly (score = 6) induced by COVID-19 vaccines. The dramatic improvement after receiving either corticoids or immunoglobulin therapy supports an immune-mediated mechanism behind this acute presentation. Cases of acute encephalitis secondary to H1N1 influenza and poliomyelitis vaccines have been previously reported but those related to COVID-19 vaccines are still not yet elucidated due to the unproven causality. Further prospective studies are needed to evaluate the causal association between vaccine and NAE occurring vaccination.
adult; adverse drug reaction; algorithm; amnesia; autoimmune disease; autonomic dysfunction; case report; case study; cerebrospinal fluid; clinical article; cognitive defect; communicable disease; complication; conference abstract; coronavirus disease 2019; drug therapy; eczema; encephalitis; epileptic state; female; headache; human; hypothyroidism; immunotherapy; influenza A (H1N1); intensive care unit; medical care; medical history; neoplasm; nuclear magnetic resonance imaging; pharmacovigilance; poliomyelitis; prospective study; rheumatoid arthritis; side effect; tonic clonic seizure; university hospital; vaccination; aciclovir; cefotaxime; elasomeran; human immunoglobulin; methylprednisolone; tozinameran
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Topics:
Vaccines
Language:
English
Journal:
Allergy: European Journal of Allergy and Clinical Immunology
Year:
2023
Document Type:
Article
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