接种bnt162b2 mrna抗covid-19后发生的急性脑脊髓多根神经病变:临床病例回顾

T. Nehrych, N. Matolinets, A. Netliukh, N. Prokopenko, S. Kyryliuk
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摘要

SARS-CoV-2和接种SARS-CoV-2的副作用显示出对神经系统结构的倾向。与大量接种疫苗的个体相比,在接种COVID-19疫苗后很少观察到中枢和周围神经系统的神经系统副作用。本文报道了一个临床病例,在接受第一剂BNT162b2 mRNA疫苗后,以急性自身免疫性炎症性脑脊髓多根神经病变的形式同时损害中枢和周围神经系统。重度脑脊髓多根神经病变伴周围性四肢瘫痪、感觉障碍、球团综合征、自主神经异常,随后发生肺炎、继发性细菌性脑膜脑炎,需要长期机械通气导致气胸及多器官功能衰竭,经强化治疗1个半月后死亡。因此,急性自身免疫性炎症性脑脊髓多根神经病变可被认为是使用基于mrna的疫苗接种SARS-CoV-2后可能出现的罕见神经系统并发症。脑脊髓多根神经病变病程严重,伴有多种并发症,可导致死亡。建立罕见神经病变发生与mrna疫苗接种SARS-CoV-2密切相关的因果关系,需要进一步的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
ACUTE ENCEPHALOMYELOPOLYRADICULONEUROPATHY THAT OCCURRED AFTER BNT162B2 MRNA VACCINATION AGAINST COVID-19: A CLINICAL CASE REVIEW
SARS-CoV-2 and side effects of SARS-CoV-2 vaccination show tropism to nervous system structures. Neurological side effects from the central and peripheral nervous systems have been observed quite rarely after vaccination against COVID-19 compared to a large number of vaccinated individuals. The article presents a clinical case of simultaneous damage to the central and peripheral nervous systems in the form of acute autoimmune inflammatory encephalomyelopolyradiculoneuropathy, which occurred after receiving the first dose of the BNT162b2 mRNA vaccine. The severe course of encephalomyelopolyradiculoneuropathy with peripheral tetraplegia, sensory disturbances, bulbar syndrome, and dysautonomia, followed by the occurrence of pneumonia, secondary bacterial meningoencephalitis, the need for long-term mechanical ventilation led to the occurrence of pneumothorax and multiple organ failure, which caused the patient’s death after one and a half months of intensive therapy. Thus, the acute autoimmune inflammatory encephalomyelopolyradiculoneuropathy can be considered as a probable rare neurological complication of SARS-CoV-2 vaccination with mRNA-based vaccines. Encephalomyelopolyradiculoneuropathy can have a severe course, accompanied by multiple complications and leading to death. Establishing of the causal relationships of the occurrence of rare neurological pathological conditions close in time to vaccination against SARS-CoV-2 with mRNA-based vaccines requires additional further researches.
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