Early-Onset Myasthenia Gravis Following COVID-19 Vaccination

Abstract

As coronavirus disease 2019 (COVID-19) has spread worldwide, the rate of COVID-19 vaccination uptake is encouraging. Neurological complications associated with COVID-19 vaccines such as stroke, Guillain-Barré syndrome, and Bell’s palsy have been reported. Recently, late-onset myasthenia gravis (MG) following COVID-19 vaccination has been reported. To date, however, there has been no evidence of increased risk of early-onset MG following COVID-19. Here, we report a case of a patient with new-onset MG that arose after receiving a COVID-19 vaccine. A 33-year-old woman suddenly experienced generalized weakness and diplopia on the evening she had received the second dose of the Pfizer-BioNTech COVID-19 vaccine. The temporal relationship suggests that this new-onset MG is related to the vaccination. It also implies that COVID-19 vaccination could trigger early-onset MG symptoms in patients at risk of MG.

Myasthenia gravis with ocular symptoms following a ChAdOx1 nCoV-19 vaccination: A case report

“… 27 , 28 Also, a few cases of myasthenia gravis following nCoV-19 vaccination have recently been published. 14 , 15 , 16 , 17 , 18 One case developed myasthenia gravis after the ChAdOx1 nCoV-19 vaccine administration, 15 as in this case, and some cases developed myasthenia gravis after administration of other types of vaccines. 14 , 16 , 17 , 18 Among them, there were four case reports of generalized myasthenia gravis, occurring after the second dose of BNT162b2 (Pfizer-BioNTech) 14 , 16 , 18 and after the second dose of Moderna nCoV-19 vaccination, and one case report of myasthenia gravis with ocular symptoms only.…”

“… 14 , 15 , 16 , 17 , 18 One case developed myasthenia gravis after the ChAdOx1 nCoV-19 vaccine administration, 15 as in this case, and some cases developed myasthenia gravis after administration of other types of vaccines. 14 , 16 , 17 , 18 Among them, there were four case reports of generalized myasthenia gravis, occurring after the second dose of BNT162b2 (Pfizer-BioNTech) 14 , 16 , 18 and after the second dose of Moderna nCoV-19 vaccination, and one case report of myasthenia gravis with ocular symptoms only. 15 In one case report, a patient who had only ocular symptoms exhibited left-sided ptosis eight days after receiving his first dose of ChAdOx1 nCoV-19 vaccination.…”

“…Until now, only a few cases of myasthenia gravis following nCoV-19 vaccination have been published. 14 , 15 , 16 , 17 , 18 …”

Case Reports of Acute Transverse Myelitis Associated With mRNA Vaccine for COVID-19

“…Out of these adverse events, 4.3% were reported as serious events, excluding death or anaphylaxis. 14 15 16 The vaccines for COVID-19 received emergency approval. There was limited time to observe the side effects after vaccination.…”

New-Onset Ocular Myasthenia Gravis After Booster Dose of COVID-19 Vaccine

“…Positive antibodies to the nicotinic acetylcholine receptor (nAChR) are the most specific finding for the diagnosis, although, in approximately half of the patients with ocular MG, the titer will be negative [1]. Coronavirus disease 2019 (COVID-19) vaccines have been reported as possible triggers for the production of antibodies pathogenic to the peripheral nerve and neuromuscular junction [2][3][4][5]. However, MG following COVID-19 vaccination is rarely reported [3][4][5].…”