GUILLAIN-BARRÉ SYNDROME AND COVID-19 VACCINATION: A DISCONCERTING ASSOCIATION
DOI:
https://doi.org/10.22159/ajpcr.2022.v15i10.45364Keywords:
Guillain-Barre syndrome, acute inflammatory demyelinating polyneuropathy, COVID-19, COVID-19 vaccine, adenoviruses –vector vaccine, messenger-RNA vaccineAbstract
Guillain-Barré syndrome (GBS) is an acute, inflammatory peripheral nerve disorder characterized by rapidly progressive, ascending, symmetrical paresthesia, and motor weakness. Some patients may develop respiratory failure requiring ventilation. The annual incidence of GBS is ~1.7 persons per 100,000 population. We describe the case of a 61-year-old male complaining of headache, one episode of vomiting, giddiness, slight slurring of speech, and inability to close his left eyelid. The patient received intravenous immunoglobulin therapy, with improvement in his symptoms at the time of discharge. In addition, we have also summarized 41 cases of GBS reported on post-COVID-19 vaccination. The intention of this case report is to highlight on the incidence of GBS in individuals who have received COVID-19 vaccine. Moreover, physicians should be aware of GBS in every patient presenting with neurological complaints on OPD.
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Vellozzi C, Iqbal S, Broder K. Guillain-Barre syndrome, influenza, and influenza vaccination: The epidemiologic evidence. Clin Infect Dis 2014;58:1149-55. doi: 10.1093/cid/ciu005, PMID 24415636
Rosenblum HG, Hadler SC, Moulia D, Shimabukuro TT, Su JR, Tepper NK, et al. Use of COVID-19 vaccines after reports of adverse events among adult recipients of Janssen (Johnson and Johnson) and mRNA COVID-19 vaccines (Pfizer-BioNTech and Moderna): Update from the advisory committee on immunization practices-United States, July 2021. MMWR Morb Mortal Wkly Rep 2021;70:1094-9. doi: 10.15585/mmwr.mm7032e4, PMID 34383735
Sejvar JJ, Baughman AL, Wise M, Morgan OW. Population incidence of Guillain-Barré syndrome: A systematic review and meta-analysis. Neuroepidemiology 2011;36:123-33. doi: 10.1159/000324710, PMID 21422765
Keddie S, Pakpoor J, Mousele C, Pipis M, Machado PM, Foster M, et al. Epidemiological and cohort study finds no association between COVID-19 and Guillain-Barré syndrome. Brain 2021;144:682-93. doi: 10.1093/brain/awaa433, PMID 33313649
Lunn MP, Cornblath DR, Jacobs BC, Querol L, van Doorn PA, Hughes RA, et al. COVID-19 vaccine and Guillain-Barré syndrome: Let’s not leap to associations. Brain 2021;144:357-60.
Waheed S, Bayas A, Hindi F, Rizvi Z, Espinosa PS. Neurological complications of COVID-19: Guillain-Barre syndrome following Pfizer COVID-19 vaccine. Cureus 2021;13:e13426. doi: 10.7759/ cureus.13426, PMID 33758714
Kanabar G, Wilkinson P. Guillain-Barré syndrome presenting with facial diplegia following COVID‐19 vaccination in two patients. BMJ Case Rep 2021;14:e244527. doi: 10.1136/bcr-2021-244527, PMID 34649856
Allen CM, Ramsamy S, Tarr AW, Tighe PJ, Irving WL, Tanasescu R, et al. Guillain-Barré syndrome variant occurring after SARS-CoV-2 vaccination. Ann Neurol 2021;90:315-8. doi: 10.1002/ana.26144, PMID 34114269
Nasuelli NA, De Marchi F, Cecchin M, De Paoli I, Onorato S, Pettinaroli R, et al. A case of acute demyelinating polyradiculoneuropathy with bilateral facial palsy after ChAdOx1 nCoV-19 vaccine. Neurol Sci 2021;42:4747-9. doi: 10.1007/s10072-021-05467-w, PMID 34272622
Patel SU, Khurram R, Lakhani A, Quirk B. Guillain-Barre syndrome following the first dose of the chimpanzee adenovirus-vectored COVID-19 vaccine, ChAdOx1. BMJ Case Rep 2021;14:e242956. doi: 10.1136/bcr-2021-242956, PMID 33888484
Maramattom BV, Krishnan P, Paul R, Padmanabhan S, Nampoothiri SC, Syed AA, et al. Guillain-Barré syndrome following ChAdOx1-S/ nCoV-19 vaccine. Ann Neurol 2021;90:312-4. doi: 10.1002/ana.26143, PMID 34114256
Min YG, Ju W, Ha YE, Ban JJ, Lee SA, Sung JJ, et al. Sensory Guillain- Barre syndrome following the ChAdOx1 nCov-19 vaccine: Report of two cases and review of literature. J Neuroimmunol 2021;359:577691. doi: 10.1016/j.jneuroim.2021.577691, PMID 34416410
Oo WM, Giri P, De Souza A. AstraZeneca COVID-19 vaccine and Guillain-Barré syndrome in Tasmania: A causal link? J Neuroimmunol 2021;360:577719. doi: 10.1016/j.jneuroim.2021.577719, PMID 34560365
Azam S, Khalil A, Taha A. Guillain-Barré syndrome in a 67-year-old male post COVID-19 vaccination (Astra Zeneca). Am J Med Case Rep 2021;9:424-7. doi: 10.12691/ajmcr-9-8-10
Hasan T, Khan M, Khan F, Hamza G. Case of Guillain-Barré syndrome following COVID-19 vaccine. BMJ Case Rep 2021;14:e243629. doi: 10.1136/bcr-2021-243629, PMID 34187803
Introna A, Caputo F, Santoro C, Guerra T, Ucci M, Mezzapesa DM, et al. Guillain-Barré syndrome after AstraZeneca COVID-19-vaccination: A causal or casual association? Clin Neurol Neurosurg 2021;208:106887. doi: 10.1016/j.clineuro.2021.106887, PMID 34418708
Kripalani Y, Lakkappan V, Parulekar L, Shaikh A, Singh R, Vyas P. A rare case of Guillain-Barre syndrome following COVID-19 vaccination. Eur J Case Rep Intern Med 2021;8:002707. doi: 10.12890/2021_002797, PMID 34671572
McKean N, Chircop C. Guillain-Barré syndrome after COVID-19 vaccination. BMJ Case Rep 2021;14:e244125. doi: 10.1136/bcr-2021- 244125, PMID 34330729
Finsterer J. Exacerbating Guillain-Barré syndrome eight days after vector-based COVID-19 vaccination. Case Rep Infect Dis 2021;2021:3619131. doi: 10.1155/2021/3619131, PMID 34055430
Bouattour N, Hdiji O, Sakka S, Fakhfakh E, Moalla K, Daoud S, et al. Guillain-Barré syndrome following the first dose of Pfizer-BioNTech COVID-19 vaccine: Case report and review of reported cases. Neurol Sci 2022;43:755-61. doi: 10.1007/s10072-021-05733-x, PMID 34796417
Razok A, Shams A, Almeer A, Zahid M. Post-COVID-19 vaccine Guillain-Barré syndrome; First reported case from Qatar. Ann Med Surg (Lond) 2021;67:102540. doi: 10.1016/j.amsu.2021.102540, PMID 34249353
Ogbebor O, Seth H, Min Z, Bhanot N. Guillain-Barré syndrome following the first dose of SARS-CoV-2 vaccine: A temporal occurrence, not a causal association. IDCases 2021;24:e01143. doi: 10.1016/j. idcr.2021.e01143, PMID 33968610
Trimboli M, Zoleo P, Arabia G, Gambardella A. Guillain-Barré syndrome following BNT162b2 COVID-19 vaccine. Neurol Sci 2021;42:4401-2. doi: 10.1007/s10072-021-05523-5, PMID 34346014
Scendoni R, Petrelli C, Scaloni G, Logullo FO. Electromyoneurography and laboratory findings in a case of Guillain-Barré syndrome after second dose of Pfizer COVID-19 vaccine. Hum Vaccin Immunother 2021;17:4093-6. doi: 10.1080/21645515.2021.1954826, PMID 34347563
Nishiguchi Y, Matsuyama H, Maeda K, Shindo A, Tomimoto H. Miller fisher syndrome following BNT162b2 mRNA coronavirus 2019 vaccination. BMC Neurol 2021;21:452. doi: 10.1186/s12883-021- 02489-x, PMID 34789193
Rao SJ, Khurana S, Murthy G, Dawson ET, Jazebi N, Haas CJ. A case of Guillain-Barre syndrome following Pfizer COVID-19 vaccine. J Community Hosp Intern Med Perspect 2021;11:597-600. doi: 10.1080/20009666.2021.1954284, PMID 34567447
Fukushima T, Tomita M, Ikeda S, Hattori N. A case of sensory ataxic Guillain-Barré syndrome with immunoglobulin G anti-GM1 antibodies following the first dose of mRNA COVID-19 vaccine BNT162b2 (Pfizer). QJM 2022;115:25-7. doi: 10.1093/qjmed/hcab296, PMID 34871447
Abo-Zed A, Pinevich A. Guillain-Barré syndrome, or acute on chronic inflammatory demyelinating polyneuropathy, following moderna COVID-19 vaccine. Chest 2021;160:A898.
Dalwadi V, Hancock D, Ballout AA, Geraci A. Axonal-variant Guillian-Barre syndrome temporally associated with mRNA-based moderna SARS-CoV-2 vaccine. Cureus 2021;13:e18291. doi: 10.7759/ cureus.18291, PMID 34722067
Matarneh AS, Al-battah AH, Farooqui K, Ghamoodi M, Alhatou M. COVID-19 vaccine causing Guillain-Barre syndrome, a rare potential side effect. Clin Case Rep 2021;9:e04756. doi: 10.1002/ccr3.4756, PMID 34484780
Masuccio FG, Comi C, Solaro C. Guillain-Barrè syndrome following COVID-19 vaccine mRNA-1273: A case report. Acta Neurol Belg 2022;122:1369-71. doi: 10.1007/s13760-021-01838-4, PMID 34767184
Loza AM, Holroyd KB, Johnson SA, Pilgrim DM, Amato AA. Guillain- Barré syndrome in the placebo and active arms of a COVID-19 vaccine clinical trial: Temporal associations do not imply causality. Neurology 2021;96:1052-4. doi: 10.1212/WNL.0000000000011881
Prasad A, Hurlburt G, Podury S, Tandon M, Kingree S, Sriwastava S. A novel case of Bifacial Diplegia variant of Guillain-Barré syndrome following Janssen COVID-19 vaccination. Neurol Int 2021;13:404-9. doi: 10.3390/neurolint13030040, PMID 34449715
Jain E, Nuthalapati D, Babar HZ, Bloomfield D. Guillain-Barré syndrome: Inverted paralysis post-operatively in a patient with ulcerative colitis. Cureus 2021;13:e15457. doi: 10.7759/cureus.15457, PMID 34258120
Morehouse ZP, Paulus A, Jasti SA, Bing X. A rare variant of Guillain- Barre syndrome following Ad26.COV2.S vaccination. Cureus 2021;13:e18153. doi: 10.7759/cureus.18153, PMID 34703690
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Copyright (c) 2022 Sindhu Shanmugam, Selvin Gnanaraj James, Sriram Damal Kandadai, Melvin George
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