[接种 COVID-19 疫苗后的米勒-费舍/吉兰-巴雷重叠综合征]。

Gil Arturo Atzin-Vela, Celeste Araceli Monroy-Parra, Carlos Humberto González-Rodríguez
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引用次数: 0

摘要

背景:抗GQ1B综合征包括一组以抗体介导的多发性神经病为特征的疾病。吉兰巴雷综合征(GBS)和米勒-菲舍尔综合征(MFS)与 COVID-19 疫苗的应用有关:48岁男性,曾接种辉瑞生物技术公司生产的COVID-19疫苗,5天后出现视力模糊和复视,48小时后又出现构音障碍、面部偏瘫和左上肢无力。在对他进行首次评估时,发现他有眼球震颤、面部偏瘫、吞咽反射减弱、胸肢无力、双侧斜方肌和腱反射减弱。血清检查和脑核磁共振检查均未发现异常。补充了 IgG 抗神经节苷脂 GQ1b 抗体,结果呈阳性。确诊后,开始使用免疫球蛋白治疗,按每公斤 2 克计算,连用 5 天。注射免疫球蛋白两个月后,患者经评估无共济失调、眼肌麻痹、手足无措和乏力症状,即可出院:在接种疫苗后继发 GBS 及其变异型的文献报道中,神经系统副作用已被列为非常重要的副作用。因此,本病例可作为一个参考点,在接种疫苗后出现神经系统症状的患者中将这种临床表现作为一种鉴别诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Miller-Fisher/Guillain-Barré overlap syndrome following COVID-19 vaccination].

Background: Anti-GQ1B syndrome includes a group of diseases characterized by antibody-mediated polyneuropathy. Guillain Barre syndrome (GBS) and the Miller-Fisher syndrome (MFS) have been related to COVID-19 vaccine application.

Clinic case: 48-year-old man, with history of Pfizer-BioNTech vaccination against COVID-19, 5 days prior to the symptoms, who assisted to the Emergency room with blurred vision and diplopia; adding dysarthria, facial diplegia and left upper limb weakness after 48 hours. In his first evaluation it was found ophthalmoplegia, facial diplegia, decreased gag reflex, weakness of thoracic limbs, bilateral trapezius muscle and areflexia. Serum studies and nuclear magnetic resonance of the brain were performed without alterations. It was complemented with IgG anti-ganglioside GQ1b antibodies with a positive result. Once the diagnosis was confirmed, treatment was started with immunoglobulin calculated at 2 g per kg for 5 days. The patient was discharged once the immunoglobulin was administered with evaluation at 2 months without ataxia, ophthalmoplegia, areflexia and weakness.

Conclusions: Following the documented reports of GBS and its variants secondary to vaccination, neurological side effects have been catalogued as being of great importance. Therefore, the reported case can be used as a point of reference to consider this clinical spectrum as a differential diagnosis in patients with post-vaccination neurological symptomatology.

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