Staff View: Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report

Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report

Background: Transverse myelitis (TM) is a relatively uncommon condition, and vaccine-associated myelitis is even rarer. Concern regarding neurological complications following vaccination escalated following the report of TM during the safety and efcacy trials of the COVID-19 vaccine. Case presentati...

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Main Authors:	Tan, Wee Yong, Yusof Khan, Abdul Hanif Khan, Mohd Yaakob, Mohd Naim, Abdul Rashid, Anna Misyail, Loh, Wei Chao, Baharin, Janudin, Ibrahim, Azliza, Ismail, Mohd Redzuan, Inche Mat, Liyana Najwa, Wan Sulaiman, Wan Aliaa, Basri, Hamidon, Hoo, Fan Kee
Format:	Article
Published:	BioMed Central 2021
Online Access:	http://psasir.upm.edu.my/id/eprint/94049/ https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-021-02427-x
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spelling	my.upm.eprints.940492023-03-06T04:20:58Z http://psasir.upm.edu.my/id/eprint/94049/ Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report Tan, Wee Yong Yusof Khan, Abdul Hanif Khan Mohd Yaakob, Mohd Naim Abdul Rashid, Anna Misyail Loh, Wei Chao Baharin, Janudin Ibrahim, Azliza Ismail, Mohd Redzuan Inche Mat, Liyana Najwa Wan Sulaiman, Wan Aliaa Basri, Hamidon Hoo, Fan Kee Background: Transverse myelitis (TM) is a relatively uncommon condition, and vaccine-associated myelitis is even rarer. Concern regarding neurological complications following vaccination escalated following the report of TM during the safety and efcacy trials of the COVID-19 vaccine. Case presentation: We report the frst case of Longitudinal Extensive Transverse Myelitis (LETM) in Malaysia following administration of the chimpanzee adenovirus-vectored (ChAdOx1 nCoV-19) vaccine. A 25-year-old female presented with bilateral lower limb weakness and inability to walk with a sensory level up to T8 with absent visual symptoms. Urgent gadolinium-enhanced magnetic resonance imaging (MRI) of the spine showed long segment TM over the thoracic region. Cerebrospinal fuid autoantibodies for anti-aquaporin-4 and anti-myelin-oligodendrocyte were negative. A diagnosis of LETM following vaccination was made, and the patient was started on a high dose of intravenous methylprednisolone. The patient eventually made a recovery following treatment. Conclusion: LETM is a rare but serious adverse reaction following vaccination. Previously reported cases showed an onset of symptoms between 10 to 14days post-vaccination, suggesting a delayed immunogenic reaction. However, the incidence of myelitis in COVID-19 is much more common, far greater than the risk associated with vaccination. BioMed Central 2021-10-12 Article PeerReviewed Tan, Wee Yong and Yusof Khan, Abdul Hanif Khan and Mohd Yaakob, Mohd Naim and Abdul Rashid, Anna Misyail and Loh, Wei Chao and Baharin, Janudin and Ibrahim, Azliza and Ismail, Mohd Redzuan and Inche Mat, Liyana Najwa and Wan Sulaiman, Wan Aliaa and Basri, Hamidon and Hoo, Fan Kee (2021) Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report. BMC Neurology, 21. pp. 1-4. ISSN 1471-2377 https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-021-02427-x 10.1186/s12883-021-02427-x
institution	Universiti Putra Malaysia
building	UPM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Putra Malaysia
content_source	UPM Institutional Repository
url_provider	http://psasir.upm.edu.my/
description	Background: Transverse myelitis (TM) is a relatively uncommon condition, and vaccine-associated myelitis is even rarer. Concern regarding neurological complications following vaccination escalated following the report of TM during the safety and efcacy trials of the COVID-19 vaccine. Case presentation: We report the frst case of Longitudinal Extensive Transverse Myelitis (LETM) in Malaysia following administration of the chimpanzee adenovirus-vectored (ChAdOx1 nCoV-19) vaccine. A 25-year-old female presented with bilateral lower limb weakness and inability to walk with a sensory level up to T8 with absent visual symptoms. Urgent gadolinium-enhanced magnetic resonance imaging (MRI) of the spine showed long segment TM over the thoracic region. Cerebrospinal fuid autoantibodies for anti-aquaporin-4 and anti-myelin-oligodendrocyte were negative. A diagnosis of LETM following vaccination was made, and the patient was started on a high dose of intravenous methylprednisolone. The patient eventually made a recovery following treatment. Conclusion: LETM is a rare but serious adverse reaction following vaccination. Previously reported cases showed an onset of symptoms between 10 to 14days post-vaccination, suggesting a delayed immunogenic reaction. However, the incidence of myelitis in COVID-19 is much more common, far greater than the risk associated with vaccination.
format	Article
author	Tan, Wee Yong Yusof Khan, Abdul Hanif Khan Mohd Yaakob, Mohd Naim Abdul Rashid, Anna Misyail Loh, Wei Chao Baharin, Janudin Ibrahim, Azliza Ismail, Mohd Redzuan Inche Mat, Liyana Najwa Wan Sulaiman, Wan Aliaa Basri, Hamidon Hoo, Fan Kee
spellingShingle	Tan, Wee Yong Yusof Khan, Abdul Hanif Khan Mohd Yaakob, Mohd Naim Abdul Rashid, Anna Misyail Loh, Wei Chao Baharin, Janudin Ibrahim, Azliza Ismail, Mohd Redzuan Inche Mat, Liyana Najwa Wan Sulaiman, Wan Aliaa Basri, Hamidon Hoo, Fan Kee Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report
author_facet	Tan, Wee Yong Yusof Khan, Abdul Hanif Khan Mohd Yaakob, Mohd Naim Abdul Rashid, Anna Misyail Loh, Wei Chao Baharin, Janudin Ibrahim, Azliza Ismail, Mohd Redzuan Inche Mat, Liyana Najwa Wan Sulaiman, Wan Aliaa Basri, Hamidon Hoo, Fan Kee
author_sort	Tan, Wee Yong
title	Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report
title_short	Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report
title_full	Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report
title_fullStr	Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report
title_full_unstemmed	Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report
title_sort	longitudinal extensive transverse myelitis following chadox1 ncov-19 vaccine: a case report
publisher	BioMed Central
publishDate	2021
url	http://psasir.upm.edu.my/id/eprint/94049/ https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-021-02427-x
_version_	1759690985769533440
score	13.211869

Longitudinal extensive transverse myelitis following ChAdOx1 nCOV-19 vaccine: a case report

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