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MDPI - Children: COVID-19 Vaccine—A Potential Trigger for MOGAD Transverse Myelitis in a Teenager—A Case Report and a Review of the Literature

Emily

Editor, Senior Moderator
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9139812/

Mărginean CO, Meliț LE, Cucuiet MT, Cucuiet M, Rațiu M, Săsăran MO. COVID-19 Vaccine-A Potential Trigger for MOGAD Transverse Myelitis in a Teenager-A Case Report and a Review of the Literature. Children (Basel). 2022 May 6;9(5):674. doi: 10.3390/children9050674. PMID: 35626851; PMCID: PMC9139812.
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2. Case Report


2.1. Presenting Concerns

We present the case of a 15-year-old male teenager admitted to our clinic for bilateral motor deficit of the lower limbs associated with the impossibility to defecate for 48 h prior to admission and to urinate for approximately 10 hours. The symptoms developed progressively with severe fatigue within the last week and the impossibility to stand occurring approximately 36 hours before admission. The anamnesis found that he was vaccinated for COVID-19 approximately 6 weeks before admission to our clinic, but without any signs of infection prior to the onset of these symptoms.

....

MOGADs have a low incidence of approximately 1.1–2.4/million people [21]. The incidence of these disorders in pediatric patients is 3.1 per million children, considerably higher in comparison to adult populations [10]. Isolated TM might occur in approximately 20% of the patients with MOGAD but might also be associated with ON in an additional 8–15% of the cases [13,22,23]. Moreover, an association between TM and ADEM was also reported in 17% of the patients [15]. Our case presented no clinical or neuroimaging signs of ON or ADEM. Similar to aquaporin 4-positive neuromyelitis optica spectrum disorders (AQP4-positive NMOSD), the onset of MOGAD seems to be related to a previous acute infection or vaccination [24]. Thus, during the global pandemic, a series of MOGAD cases related to SARS-CoV-2 infection were reported [25,26,27]. In addition, a recent reported case described MOGAD encephalomyelitis in a 43-year-old woman following COVID-19 vaccination [28]. Similarly, occasional cases of inflammatory CNS disorders were also described following COVID-19 vaccination, such as seronegative NMOSD-like associated with multiple sclerosis, but also a patient with AQP4-positive NMOSD [29,30]. MOGAD-LETM occurred in our patient approximately 6 weeks after his second dose of COVID-19 vaccine (Pfizer), suggesting that this vaccine might have an effect on the occurrence of the acute attack in this case since we did not find any other triggers...
 
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