Reactions 1871, p134 - 4 Sep 2021
Covid-19-vaccine-pfizer-biontech
S Guillain-Barre syndrome: case reportA 73-year-old man developed Guillain-Barre syndrome following an administration of second dose of Covid-19-vaccine-pfizer- biontech.
The man, who had a history of hypertension and well-controlled rheumatoid arthritis, was admitted with 3–4 days history of progressive bilateral lower limb weakness. He was an active smoker. Twenty days prior to the admission, he received second dose of Covid-19-vaccine-pfizer-biontech [dose and route not stated]. Physical examination revealed that his vitals were stable and he was afebrile. Neurological examination revealed intact sensation in both upper and lower limbs. Motor strength was 5/5 in upper limbs and 3/5 in both lower limbs, proximally and distally. He was not able to walk or maintain sitting posture. Reflexes were absent in the ankles, reduced in the knees bilaterally (2/4) and normal in the upper limbs. Complete blood count revealed mild leukocytosis of 11.9×103/µL with neutrophilic predominance. C-reactive protein was increased to 54 mg/dl. He was tested negative for COVID-19 infection. Brain CT and brain MRI were negative for any acute change in the brainstem and cerebellum. Cerebrospinal fluid analysis revealed normal glucose along with normal white and red blood cell counts. CSF examination revealed increased protein at 0.8 gm/L and increased albumin at 421 mg/L. Gram stain and culture of the fluid were negative. Spine MRI revealed bilateral nerve root enhancement in the lumbar region and the upper part of the cauda equina. Nerve conduction study and electromyogram revealed bilateral absent H reflexes in the gastrocnemius muscles consistent with early polyneuroradiculopathy.
Based on findings, he was diagnosed with Guillain-Barre syndrome.
The man received human IV immune-globulin (IVIG) for 5 days. His symptoms were improved. Ambulation and overall function was also improved. Twelve days following the admission, he was transferred to an inpatient rehabilitation facility. He received extensive physical and occupational therapy for two months. Later, he was discharged. Three weeks later, examination revealed that his muscle power and functional status were full recovered.
Razok A, et al. Post-COVID-19 vaccine Guillain-Barre syndrome; first reported case from Qatar. Annals of Medicine and Surgery 67: 102540, Jul 2021. Available from:
URL: http://www.elsevier.com/journals/annals-of-medicine-and-surgery/2049-0801 803591981
1
Reactions 4 Sep 2021 No. 1871 0114-9954/21/1871-0001/$14.95 Adis © 2021 Springer Nature Switzerland AG. All rights reserved
