Neurological autoimmune diseases following vaccinations against SARS-CoV-2: a case series
Background and purpose Population-based studies suggest that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines may trigger immune-mediated thrombotic thrombocytopenia (VITT) raising concerns for other autoimmune responses. The aim was to characterize neurological autoimmunity aft...
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| Hauptverfasser: | , , , , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
2022
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| In: |
European journal of neurology
Year: 2022, Jahrgang: 29, Heft: 2, Pages: 555-563 |
| ISSN: | 1468-1331 |
| DOI: | 10.1111/ene.15147 |
| Online-Zugang: | Verlag, kostenfrei, Volltext: https://doi.org/10.1111/ene.15147 Verlag, kostenfrei, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/ene.15147 
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| Verfasserangaben: | Leon D. Kaulen, Sofia Doubrovinskaia, Christoph Mooshage, Berit Jordan, Jan Purrucker, Carmen Haubner, Corinna Seliger, Hanns-Martin Lorenz, Simon Nagel, Brigitte Wildemann, Martin Bendszus, Wolfgang Wick, Silvia Schönenberger |
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| 245 | 1 | 0 | |a Neurological autoimmune diseases following vaccinations against SARS-CoV-2 |b a case series |c Leon D. Kaulen, Sofia Doubrovinskaia, Christoph Mooshage, Berit Jordan, Jan Purrucker, Carmen Haubner, Corinna Seliger, Hanns-Martin Lorenz, Simon Nagel, Brigitte Wildemann, Martin Bendszus, Wolfgang Wick, Silvia Schönenberger |
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| 500 | |a First published: 19 October 2021 | ||
| 500 | |a Gesehen am 09.01.2023 | ||
| 520 | |a Background and purpose Population-based studies suggest that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines may trigger immune-mediated thrombotic thrombocytopenia (VITT) raising concerns for other autoimmune responses. The aim was to characterize neurological autoimmunity after SARS-CoV-2 vaccinations. Methods In this single-centre prospective case study patients with neurological autoimmunity in temporal association (≤6 weeks) with SARS-CoV-2 vaccinations and without other triggers are reported. Clinical, laboratory and imaging data were collected with a median follow-up of 49 days. Results In the study period 232,603 inhabitants from the main catchment area of our hospital (Rhein-Neckar-Kreis, county) received SARS-CoV-2 vaccinations. Twenty-one cases (new onset n = 17, flares n = 4) diagnosed a median of 11 days (range 3-23) following SARS-CoV-2 vaccinations (BNT162b2 n = 12, ChAdOx1 n = 8, mRNA-1273 n = 1) were identified. Cases included VITT with cerebral venous sinus thrombosis (n = 3), central nervous system demyelinating diseases (n = 8), inflammatory peripheral neuropathies (n = 4), myositis (n = 3), myasthenia (n = 1), limbic encephalitis (n = 1) and giant cell arteritis (n = 1). Patients were predominantly female (ratio 3.2:1) and the median age at diagnosis was 50 years (range 22-86). Therapy included administration of steroids (n = 15), intravenous immunoglobulins in patients with Guillain-Barré syndrome or VITT (n = 4), plasma exchange in cases unresponsive to steroids (n = 3) and anticoagulation in VITT. Outcomes were favourable with partial and complete remissions achieved in 71% and 24%, respectively. Two patients received their second vaccination without further aggravation of autoimmune symptoms under low-dose immunosuppressants. Conclusions In this study various neurological autoimmune disorders encountered following SARS-CoV-2 vaccinations are characterized. Given the assumed low incidence and mostly favourable outcome of autoimmune responses, the benefits of vaccinations outweigh the comparatively small risks. | ||
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| 650 | 4 | |a cerebral venous sinus thrombosis | |
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| 650 | 4 | |a myelitis | |
| 650 | 4 | |a myositis | |
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