与 COVID 19 感染和疫苗接种有关的急性横贯性脊髓炎(ATM):病例报告和文献综述。

IF 3.1 Q2 NEUROSCIENCES
AIMS Neuroscience Pub Date : 2024-06-11 eCollection Date: 2024-01-01 DOI:10.3934/Neuroscience.2024011
Srinivas Medavarapu, Nitasha Goyal, Yaacov Anziska
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引用次数: 0

摘要

急性横贯性脊髓炎(ATM)是一种由多种病因引起的炎症性疾病,包括感染后和自身免疫性疾病。COVID-19感染后和接种COVID-19疫苗后均出现ATM病例的报道十分罕见。我们描述了感染 COVID-19 后的 ATM 病例,并进行了文献综述:我们报告了一例感染 COVID-19 后纵向广泛分布的 ATM 病例,该患者也接受了康复血浆治疗,并对报告的感染 COVID-19 和接种 COVID-19 疫苗后的 ATM 病例进行了全面的文献综述。文献检索通过PubMed和Google scholar进行,检索关键词为选定的同行评议文章。检索包括2020年1月至2022年9月的所有病例:共有60例ATM病例报告与COVID 19感染后有关,23例ATM病例报告与COVID 19疫苗接种后有关。在 COVID 19 疫苗接种后感染的 ATM 病例中,平均年龄为 49 岁,最小年龄为 7 个月大。共有55%(33例)的病例为纵向广泛性ATM。最常见的症状是下肢无力。一例病例活检报告为坏死性脊髓炎,另一例病例则与 GBS 和纵向广泛性 ATM 综合征重叠。没有病例报告在感染后使用康复血浆疗法。几乎所有的 ATM 病例都接受了类固醇治疗,但有些病例需要额外的治疗,因为并非所有病例都有充分的反应。有 6 个病例(10%)对类固醇加血浆置换疗法有反应,有 5 个病例(8%)对类固醇加 IVIG 有反应,尤其是在儿童年龄组。一个病例在使用依库珠单抗治疗后出现了阳性反应,另一个病例在使用英夫利昔单抗治疗后也出现了阳性反应。有两个病例(3%)仍然瘫痪。在接种covid-19疫苗后的ATM病例中,有4例(17%)报告为纵向广泛性ATM。5例(21%)在接种疫苗后一周内出现症状。除一例在接种后第 58 天死亡外,几乎所有病例都对类固醇有反应:ATM是COVID-19急性感染的一种罕见并发症,已有多例病例报道。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Acute transverse myelitis (ATM) associated with COVID 19 infection and vaccination: A case report and literature review.

Acute transverse myelitis (ATM) is an inflammatory disorder caused by many etiologies, from postinfectious to autoimmune. Rarely, ATM cases have been reported after both COVID-19 infection and COVID-19 vaccination. We described our experience with ATM after COVID-19 infection and conducted a literature review.

Case finding methods: We reported a case of longitudinally extensive ATM after COVID 19 infection, who also received convalescent plasma therapy, and present a comprehensive literature review of ATM cases reported after COVID-19 infection and COVID-19 vaccination. The literature search was done using PubMed and Google scholar with keywords and selected peer-reviewed articles. The search included all cases from Jan 2020 to Sept 2022.

Results: A total of 60 ATM cases reported association with post COVID 19 infection, and 23 ATM cases reported association with post COVID 19 vaccinations. Among post COVID 19 ATM cases, the mean age was 49 years and the youngest reported was 7-month-old. A total of 55% (33) were longitudinally extensive ATM. The most common symptom was lower extremity weakness. One case was reported as necrotizing myelitis on biopsy, and another case overlapped with syndrome of GBS and longitudinal ATM. No cases reported using convalescent plasma therapy after infection. Almost all the ATM cases were treated with steroids, but some cases needed additional treatment since not all responded adequately. Six cases (10%) responded with steroids plus plasmapheresis, and 5 cases (8%) responded with steroids + IVIG, especially in the pediatric age group. One case reported a positive response after treatment with eculizumab, and another with infliximab. Two cases (3%) remained paraparetic. Among post covid-19 vaccine ATM cases, 4 cases (17%) were reported as longitudinally extensive ATM. Five cases (21%) had symptom onset within a week after vaccination. Almost all reported a response to steroids except for one case which reported fatality after the 58th day after vaccination.

Conclusion: ATM, in the setting of acute COVID-19 infection, has been described in multiple cases and is a rare complication of COVID-19 vaccination.

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来源期刊
AIMS Neuroscience
AIMS Neuroscience NEUROSCIENCES-
CiteScore
4.20
自引率
0.00%
发文量
26
审稿时长
8 weeks
期刊介绍: AIMS Neuroscience is an international Open Access journal devoted to publishing peer-reviewed, high quality, original papers from all areas in the field of neuroscience. The primary focus is to provide a forum in which to expedite the speed with which theoretical neuroscience progresses toward generating testable hypotheses. In the presence of current and developing technology that offers unprecedented access to functions of the nervous system at all levels, the journal is designed to serve the role of providing the widest variety of the best theoretical views leading to suggested studies. Single blind peer review is provided for all articles and commentaries.
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