Acute autoimmune transverse myelitis following COVID-19 vaccination: A case report. Issue 51 (23rd December 2021)

• Record Type: Journal Article
• Authors: Hirose, Satoshi; Hara, Makoto; Koda, Kento; Natori, Naotoshi; Yokota, Yuki; Ninomiya, Satoko; Nakajima, Hideto
• Editors: Saranathan., Maya
• Is Part Of: Medicine. Volume 100:Issue 51(2021)
• Page Start: e28423
• Publication Date: 2021-12-23
• Subjects: autoimmune -- COVID-19 -- oligoclonal bands -- transverse myelitis -- vaccine; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000028423
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Supplemental Digital Content is available in the text Abstract: Rationale: Transverse myelitis is an infectious or noninfectious inflammatory spinal cord syndrome. We report a rare case of transverse myelitis following vaccination against COVID-19. Patient concerns: A 70-year-old male presented with progressive sensorimotor dysfunction of the bilateral lower limbs 7 days after receiving the mRNA-1273 vaccine against COVID-19. Spinal magnetic resonance imaging revealed intramedullary lesions with gadolinium enhancement on the Th1/2 and Th5/6 vertebral levels. Cerebrospinal fluid (CSF) testing showed a mildly increased level of total protein and positive oligoclonal bands (OCB). Diagnosis: The patient was diagnosed with acute transverse myelitis. Intervention: The patient received 5 days of intravenous methylprednisolone pulse (1000 mg/day) followed by oral prednisolone (30 mg/day with gradual tapering). Outcomes: The patient fully recovered from muscle weakness of the lower limbs. He was discharged from our hospital and able to independently walk without unsteadiness. Lesson: This is a rare case of transverse myelitis following COVID-19 vaccination. Positive OCB in CSF in the present case highlights the possibility of autoimmune processes, including polyclonal activation of B lymphocytes, following vaccination.