Guillain-Barré syndrome after COVID-19 vaccination

Hundreds of presumptive cases of Guillain-Barré syndrome (GBS) were identified following adenovirus COVID-19 vaccines. Dozens of cases have been reported for mRNA vaccines.

An 80-year-old male patient presented to emergency room with chief complaints of progressive, ascending bilateral lower extremity paresthesia, and weakness following COVID-19 (Moderna) vaccine. He received his first dose of Moderna vaccine about three months after recovery from COVID-19. Soon after vaccination he noticed bilateral lower extremity paresthesia (tingling and numbness), which was followed by progressive bilateral lower limb distal weakness, beginning at his feet and then ascending to involve his legs, knees, and hips. He was unable to maintain balance and started having multiple falls prompting him to start using a walker for ambulation. He then received the second dose of his vaccine in February 2021. The next morning, he was unable to get out of his bed due to severe bilateral lower extremity weakness, and he therefore presented to the emergency room.


The patient's past medical history was notable for COVID-19 infection the previous year, from which he had an uneventful recovery, chronic lymphocytic leukemia (CLL) without the end organ involvement for which he had not received any treatment, degenerative disease of lumbar spine, remote history of TIA, hypertension, and hyperlipidemia. The patient denied recent trauma, exposure to drugs / toxins, recent infection, auto-immune disease, family history of hereditary neuropathy or personal history of smoking, alcohol, and drug dependence. 

Toward the end of his 5 days of IVIG therapy, the patient noted significant improvement in bilateral lower extremity strength and began to ambulate with help from physical therapy.

REFERENCE

Anjum Z, Iyer C, Naz S, et al. Guillain-Barré syndrome after mRNA-1273 (Moderna) COVID-19 vaccination: A case report. Clin Case Rep. 2022;10:e05733. doi:10.1002/ccr3.5733

Guillain‐Barré syndrome after mRNA‐1273 (Moderna) COVID‐19 vaccination: A case report - Anjum - 2022 - Clinical Case Reports - Wiley Online Library

See also

Hanson KE, Goddard K, Lewis N, et al. Guillain-Barré syndrome after COVID-19 vaccination in the vaccine safety datalink. medRxiv. 2021. http://medrxiv.org/content/early/ 2021/12/05/2021.12.03.21266419.abstract 19.

Woo EJ, Mba-Jonas A, Dimova RB, Alimchandani M, Zinderman CE, Nair N. Association of receipt of the Ad26. COV2.S COVID-19 vaccine with presumptive Guillain-Barré syndrome, February-July 2021. JAMA. 2021;326(16):1606-1613. 20.

Maramattom BV, Krishnan P, Paul R, et al. Guillain-Barré syndrome following ChAdOx1-S/nCoV-19 vaccine. Ann Neurol. 2021;90(2):312-314

Comments

Post a Comment

Popular posts from this blog

A New Onset of Ulcerative Colitis post-2nd-breakthrough-COVID-19

Image
A 21-year-old non-smoking Caucasian male with a history of acute pancreatitis but no other medical issues or family history had two doses of the BNT162b2 mRNA COVID-19 vaccine.  Four months after the second dose he had his first episode of COVID-19. Although not hypoxic, he felt pretty unwell for a week, with a severe cough, fever, generalized body ache, headache, and loss of taste. He received the third dose of the vaccine two months after recovering from COVID. Nine months after the third dose, he had the second episode of COVID-19, during which he was mildly unwell for three days, recovered, and did not require any anti-viral medication or antibiotics. One week post the second episode of COVID-19, he developed diarrhea and abdominal pain. It then progressed to bloody diarrhea. Ulcerative colitis was diagnosed based on his clinical symptoms, biopsy changes, and the exclusion of other causes.  There are ten published case reports about the newly diagnosed ulcerative colitis ...
Read more

COVID in May

Image
Concerns about a potential resurgence of COVID-19 are mounting as summer 2024 approaches.  This is driven by several indicators, including social media posts, healthcare data, and wastewater surveillance across different regions. Our study findings corroborate this trend.  While many forecasters anticipate a surge, others expect a gradual increase through the end of May, and then a decline again around early June. Reports from social media suggest emerging clusters of COVID-19 in Texas, several Canadian provinces, the UK, and on cruises in northern regions such as a Norwegian cruise to Alaska.  Data from Alberta's Respiratory virus dashboard   (total weekly laboratory-confirmed COVID-19 cases) and wastewater surveillance in Calgary indicate an uptick in COVID-19 cases starting April 2024. The most recent statistics from Alberta Health reveal a significant increase in hospitalizations due to COVID-19, with 114 individuals currently hospitalized—an incr...
Read more

Chronic SARS-CoV-2 Shedding

Image
Chronic viral shedding, a condition where the virus continues to be released from an individual's body long after the initial infection, has been observed in many infectious diseases, including COVID-19.  In such cases, individuals may remain asymptomatic or experience only mild symptoms while the virus persists. It remains detectable in repeated tests over an extended period and can still infect others even in nasal swab is negative (which happens quite often ). This was evident in our study.    Recent research by Conway et al. (2024) highlights the possibility of chronic SARS-CoV-2 infection, extending over several months and potentially years. Other studies have documented prolonged asymptomatic infections and extended viral shedding in moderate to severe beyond hospital discharge. Analysis of sequencing data on UK samples taken between 2 November 2020 and 15 August 2022 lead to estimates that 0.1–0.5% of infections may become persistent with typically rebounding high ...
Read more