Medical Case Reports

Encephalitis is an inflammatory condition affecting the brain, characterized by the swelling of the brain tissue. This inflammation is often triggered by viral infections, although it can also result from bacterial infections, autoimmune disorders, or vaccination.  Multiple cases have been presented in the literature.  Anti NMDA Autoimmune Encephalitis in a Pediatric Patient: Anti-NMDA receptor encephalitis is a rare autoimmune disorder that affects the central nervous system. In this condition, the body's immune system mistakenly targets and attacks NMDA receptors in the brain. NMDA receptors are essential for normal brain function, and their dysfunction can lead to a range of neurological symptoms. The condition is often associated with the presence of antibodies against the NMDA receptors. The case involves a 13-year-old female who developed anti-NMDA autoimmune encephalitis after receiving the Pfizer–BioNTech COVID-19 vaccine. The patient presented with subacute neurologic...

New case report describes a 56-year-old woman who developed debilitating symptoms, including intense foot pain, discoloration, and swelling, following COVID-19 vaccination with the Pfizer-BioNTech mRNA vaccine. The patient experienced acrocyanosis, constant pain in the soles of her feet, and a throbbing sensation. Symptoms worsened after each COVID-19 vaccine dose, leading to dependency on a wheelchair. Dermatological manifestations included redness, discoloration, and swelling. Initial evaluations suggested erythromelalgia, but subsequent investigations involved multiple medical specialties, including dermatology, vascular surgery, rheumatology, neurology, and orthopedics. Various diagnostic tests, including blood tests, genetic testing, imaging, and biopsies, yielded inconclusive results. Based on the Budapest Criteria for CRPS, the patient fulfilled the criteria, exhibiting allodynia, hyperalgesia, skin color changes, edema, continuing pain, and the absence of a more obvious ex...

Leukopenia, a condition characterized by a decrease in white blood cell count, is a medical phenomenon that warrants attention, especially when linked to the initiation of medications. In a newly published case report, a 20-year-old bipolar woman experienced leukopenia following the administration of lamotrigine, next day after COVID-19 vaccine booster, shedding light on potential risks and interactions. Lamotrigine is known for its efficacy in treating bipolar disorder, but like any medication, it comes with potential side effects. Adverse effects are more likely when lamotrigine is used alongside other antiepileptic drugs, during rapid dose titration, or in combination with multiple medications. Monitoring its concentration becomes crucial in such cases, as highlighted in this report. The patient in question received lamotrigine the day after her third mRNA vaccination for COVID-19, presenting with predisposing factors such as concomitant use of antiepileptic drugs. Surprisingly, leu...

New paper discusses a case report of a 65-year-old woman who experienced neurological complications following the administration of a third dose of the Moderna COVID-19 vaccine. The patient, previously in good health, presented with symptoms that included numbness in the mouth, feet, legs, interscapular space, and hands, along with muscle pain in the lower limbs and interscapular pain. The clinical evaluation by a neurologist revealed distal and asymmetric sensory axonal polyneuropathy predominantly affecting the right lower limb. Electromyography (EMG) and electroneurography (ENG) tests were conducted to assess the nerve function. The study showed an exclusively sensory polyneuropathy of the axonal type with a distal and asymmetric distribution, predominantly in the right lower limb. There were also findings suggestive of neuropathy due to entrapment of the distal segment of the right median nerve in its course through the wrist.  The patient's blood work showed elevated transamin...

Patients with adrenal insufficiency who are on glucocorticoid replacement therapy face unique challenges when it comes to vaccination. In most cases, conventional vaccines like those for the influenza virus don't necessitate an increase in glucocorticoid dose. However, with the advent of COVID-19 mRNA vaccines, there have been reported cases of adrenal crisis in patients with secondary adrenal insufficiency. A new paper explores three cases that shed light on this issue.  Case 1: Idiopathic Isolated ACTH Deficiency A 78-year-old man with idiopathic isolated ACTH deficiency received the second dose of the BNT162b2 mRNA vaccine. He decided not to take hydrocortisone (HC) on the day of vaccination. The following day, he experienced fatigue, nausea, vomiting, and appetite loss. He did not receive HC and ended up in the emergency department two days later, with severe general fatigue, nausea, vomiting, hyponatremia, and relative hypotension. His symptoms resolved a day after administrat...