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Emna Smaoui, Khadija Sonda Moalla, Nadia Bouattour, Nouha Farhat, Salma Sakka, Sawsan Daoud, Mariem Damak and Chokri Mhiri
February 6, 2024
Pan African Medical Journal
Habib Bourguiba Hospital (Tunisia)

"Patient and observation

Patient information: a 41-year-old man, with no personal history, presented with acute worsening weakness of the lower extremities and paresthesia of the four limbs. There was no history of recent fever, nor signs of gastrointestinal or upper respiratory tract infection. The patient denied any substance or alcohol use and he had no previous SARS-CoV-2 exposure ... 

Timeline of current episode: the patient presented initially generalized arthralgia followed after 4 days by acute worsening weakness of the bilateral lower extremities with paresthesia of the four limbs. The symptoms appeared 15 days after his first dose of the AstraZeneca COVID-19 vaccine. The diagnosis of GBS [Guillain Barre Syndrome] was initially retained, and the patient was treated with 2 courses of plasma exchange with slight improvement. After four and a half months, the evolution was marked by the aggravation of the paresthesia and weakness of four limbs and the patient became unable to walk even with bilateral assistance ...

Diagnosis: the diagnosis of acute-onset CIDP [chronic inflammatory demyelinating polyneuropathy] was finally made regarding the clinical relapse occurring more than 8 weeks after the first episode and the final results of the control ENMG showing a severe CIDP. The persistence of albumin-cytological dissociation in the CSF further supports this diagnosis ... 

Discussion: The relationship between vaccines and inflammatory neuropathies has been a matter of concern since cases of GBS were discovered following the swine influenza vaccine. Accordingly, cases of GBS and more recently of CIDP have been reported following COVID-19 vaccination. Although GBS was officially recognized as a complication of COVID-19 vaccines, the causal relationship between the new occurrence of CIDP and vaccination against COVID-19 is not yet clear...

Chronic inflammatory demyelinating polyneuropathy (CIDP) developing in the post-vaccination period is unusual, estimated at 1.5% to 11% of patients. At the time of writing this paper, 19 cases of post-COVID-19 vaccination new onset CIDP or exacerbation of pre-existing CIDP were reported. Thirteen of them were diagnosed as A-CIDP ...

We found that most cases are reported after AstraZeneca vaccine, which could be explained by the nature of the vaccine being an adenovirus vector."

document
adverse events,COVID-19,demyelination,hospitalizations,neurological disorders,vaccines