Guillain‐Barré syndrome after mRNA‐1273 (Moderna) COVID‐19 vaccination: A case report

Anjum, Zauraiz; Iyer, C.; Naz, Sidra; Jaiswal, Vikash; Nepal, Gaurav; Laguio-Vila, Maryrose; Anandaram, Sanjay; Thapaliya, Sahil

doi:10.1002/ccr3.5733

Cited by 14 publications

(9 citation statements)

References 22 publications

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“…In addition, as in this case, gait disturbance due to weakness in the lower extremities occurred first in all 3 previous cases, and the general course of GBS was observed, where symptoms improved after immunoglobulin or plasmapheresis. [13][14][15] Our patient had severe form of GBS accompanied by respiratory failure but recovered without serious neurological sequelae. The possible antecedents were COVID-19 vaccine and scrub typhus, indicating that both antecedent events should be considered in clinical settings.…”

Section: Discussionmentioning

confidence: 99%

Two possible etiologies of Guillain-Barré syndrome: mRNA-1273 (Moderna) vaccination and scrub typhus: A case report

Hwang

Bong

2022

Medicine

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Rationale: Guillain-Barré syndrome (GBS) is an acute inflammatory polyneuropathy related to infection with bacteria or virus and vaccination. Cases of GBS after coronavirus infection-19 (COVID-19) vaccination have been reported. However, cases of GBS after inoculation with mRNA-based COVID-19 vaccines, especially mRNA-1273, have rarely been reported compared to after inoculation with adenovirus vector-based COVID-19 vaccines. On 1 hand, GBS occurring after scrub typhus is often reported, but the exact pathological mechanism has not been elucidated. We report the case of a patient with GBS after inoculation with mRNA-1273 COVID-19 vaccine and scrub typhus.Patient concerns: A 47-year-old man received COVID-19 vaccination 4 weeks before admission. He had a fever, rash and general weakness 1 day after vaccination. After 3 weeks, the muscle strength of the extremities deteriorated to the extent that walking was impossible. Diagnosis, interventions, and outcomes:The patient developed quadriplegia with areflexia, axonal-type sensorimotor polyneuropathy was confirmed by nerve conduction study. The patient was diagnosed as GBS. Scrub typhus was also diagnosed as eschar was observed in the chest area and the serologic test of anti-R-tsutsugamushi antibody showed a strongly positive result. The patient received treatment with intravenous immunoglobulin at 0.4 g/kg daily for 5 days. Mechanical ventilation was applied during the intensive care unit. He was treated for scrub typhus simultaneously. Six months after the onset of the disease, the patient showed improvement to the point where he could work and exercise alone.Lessons: When GBS is suspected, early evaluation and treatment can lead to favorable outcomes. Considering that cases of GBS after COVID-19 vaccination have been reported, it is important to conduct early evaluation and management of patients with muscle weakness after COVID-19 vaccination to ensure early detection of GBS. And even if fever and rash are side effects that can occur frequently after vaccination, it is necessary to consider other diseases in addition to the side effects of the vaccine. This is to prevent delay in diagnosis and treatment of other diseases.

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Section: Discussionmentioning

confidence: 99%

Two possible etiologies of Guillain-Barré syndrome: mRNA-1273 (Moderna) vaccination and scrub typhus: A case report

Hwang

Bong

2022

Medicine

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“…The underlying mechanisms for GBS with COVID-19 vaccines and other vaccines at this point is postulated to be molecular mimicry that results in cross reactivity of immune response to neuronal and myelin elements of peripheral nervous system. 6 There is growing evidence that cross reactivity of infective agent epitopes and peripheral nerve gangliosides may play a role. Several other antecedent events including surgery, cancer, pregnancy, autoimmune disease, and vaccinations(swine flu vaccine of 1976) has been linked to GBS.…”

Section: Discussionmentioning

confidence: 99%

Post COVID-19 vaccine Guillain Barre Syndrome

Khan¹,

Khalil²,

Waqar

et al. 2022

PJNS

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The Guillain Barre Syndrome (GBS) is an acute immune mediated progressive polyneuropathy having an acute monophasic illness leading to paralysis. The clinical features are progressive ascending symmetrical muscle weakness that may lead to respiratory failure. Diagnosis is based upon clinical presentation and is supported by a lumbar puncture with CSF analysis demonstrating albumin cytological dissociation and electrophysiological studies. Our patient presented to us with progressive ascending paralysis after receiving COVID 19 vaccine.

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“…7 Most evidence reports reporting instances of GBS post-COVID-19 vaccination are case reports, with 22 publications describing 26 cases ( Table 1 ). 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 Seventeen of 26 cases (65.3%) occurred in females, with an average age in reported cases of 54.6 years and an average time between vaccine receipt and symptom onset of 10.5 days. Nineteen individuals developed GBS after vaccination with BNT162b2 (73%), while 4 (15.4%) developed GBS after Ad26.COV2.S, and 3 (11.5%) after MRNA-1273 .…”

Section: Guillain–barré Syndromementioning

confidence: 99%

Neurological Considerations with COVID-19 Vaccinations

et al. 2023

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The benefits of coronavirus disease 2019 (COVID-19) vaccination significantly outweigh its risks on a public health scale, and vaccination has been crucial in controlling the spread of SARS-CoV-2. Nonetheless, several reports of adverse events following vaccination have been published.To summarize reports to date and assess the extent and quality of evidence regarding possible serious adverse neurological events following COVID-19 vaccination, focusing on Food and Drug Administration (FDA)-approved vaccines in the United States (BNT162b2, mRNA-1273, and Ad26.COV2.S).A review of literature from five major electronic databases (PubMed, Medline, Embase, Cochrane Library, and Google Scholar) was conducted between December 1, 2020 and June 5, 2022. Articles included in the review were systematic reviews and meta-analysis, cohort studies, retrospective studies, case–control studies, case series, and reports. Editorials, letters, and animal studies were excluded, since these studies did not include quantitative data regarding adverse side effects of vaccination in human subjects.Of 149 total articles and 97 (65%) were case reports or case series. Three phase 3 trials initially conducted for BNT162b2, MRNA-1273, and Ad26.COV2.S were included in the analysis.The amount and quality of evidence for possible neurological adverse events in the context of FDA-approved COVID-19 vaccinations is overall low tier. The current body of evidence continues to suggest that COVID-19 vaccinations have a high neurological safety profile; however, the risks and benefits of vaccination must continue to be closely monitored.

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Guillain‐Barré syndrome after mRNA‐1273 (Moderna) COVID‐19 vaccination: A case report

Cited by 14 publications

References 22 publications

Two possible etiologies of Guillain-Barré syndrome: mRNA-1273 (Moderna) vaccination and scrub typhus: A case report

Two possible etiologies of Guillain-Barré syndrome: mRNA-1273 (Moderna) vaccination and scrub typhus: A case report

Post COVID-19 vaccine Guillain Barre Syndrome

Neurological Considerations with COVID-19 Vaccinations

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