Thursday, September 15, 2022

Myasthenia Gravis Case Documented Following the COVID-19 Vaccine

 By Patricia Inacio, PhD 

Following a Sinopharm vaccination against SARS-CoV-2, the virus that causes COVID-19, researchers in Iran reported the first incidence of myasthenia gravis (MG).

The report comes after data suggesting a connection between the COVID-19 vaccine and MG. Even if it may seem like a rare occurrence, MG should be taken into consideration "if muscle weakness, ocular and bulbar [neck and facial] symptoms arise," the research team noted.

Published in Neuroimmunology Reports, the study was titled "A New Case of Myasthenia Gravis Following COVID-19 Vaccination."

Self-reactive antibodies assault the areas where nerve and muscle cells communicate to create MG, an uncommon autoimmune illness that results in fatigue and muscle weakening.

16 August 2022 Patricia Inacio's PhD news

Report: 3 Cases of MG Possibly Related to COVID-19 Vaccination

Several studies have connected the start of MG to SARS-CoV-2 infection. Vaccination has also been suggested as a possible factor in the deterioration of disease. However, there aren't many studies that evaluate the security and efficiency of COVID-19 vaccinations in MG patients.

Iranian researchers revealed the example of a 68-year-old man who presented to a neurology clinic with speech and swallowing issues.

Three days after receiving the second dosage of the Sinopharm COVID-19 vaccination (also known as BBIBP-CorV), he started experiencing symptoms, which worsened a month later. He was "extremely unwell and useless and could not even consume fluids" when he was admitted to the hospital, the researchers said.

The vaccine, which was made in China, comprises an inactivated variant of the SARS-CoV-2 virus, which can still elicit an immune response even if it can no longer spread illness.

The patient regarded himself "totally healthy before [getting] the vaccine" and was clear of infection both before and after the inoculation. He also had no prior medication history.

He made no claims of having a headache, feeling lightheaded, having blurry or double vision, or having any focused weakness or numbness in his limbs. He couldn't swallow, and his speech was nasal. He was drooling. There was no history of autoimmune diseases in his family.

Ptosis, or partial drooping of the upper eyelids, was discovered during a neurologic examination in both eyes. His eyes moved regularly, and his pupils responded to light. He had no asymmetry or numbness in his face. Tendon reflexes and muscle testing were both normal.

For additional testing, he was brought to the hospital. An MRI of the brain revealed no anomalies. He was negative for SARS-CoV-2 and his blood tests were normal.

Further tests were sought by doctors who detected a probable neuromuscular junction problem. The most typical type of antibody that causes MG was detected in him; these antibodies were directed towards the acetylcholine receptor (AChR).

His two face muscles were subjected to slow repeated nerve stimulation (RNS), and the results were compatible with an MG diagnosis. Electrodes are positioned over the muscles that the clinicians want to evaluate in RNS. Nerves must conduct electrical pulses in order to cause a muscular reaction. After multiple rounds of stimulation, the patient is likely to have MG if signal transmission deteriorates with tiredness.

CT and MRI scans were negative for thymoma, a tumor of the thymus gland that occasionally coexists with MG.

The patient was treated with oral prednisolone, a corticosteroid, and pyridostigmine, a medication that is frequently used to treat MG and increase muscle strength. Additionally, he got intravenous immunoglobulin (IVIG). After treatment, his condition considerably got better.

The researchers wrote that while vaccination in MG patients outweighs potential risks, "patients should be aware of the possible exacerbation or transient worsening of symptoms after vaccination." "Our case is the first case of new onset myasthenia gravis following Sinopharm vaccine that is associated with high antibody titer against the acetylcholine receptor."

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