We report the case of a 68-year-old patient who developed autoimmune myasthenia 24 hours after receiving the second dose of an inactivated SARS-CoV-2 vaccine (Sinopharm？). This patient, already followed for ischemic heart disease, presented with typical symptoms such as diplopia, bilateral ptosis, and muscle fatigability upon exertion. Investigations revealed the presence of anti-acetylcholine receptor antibodies as well as polycythemia, confirmed by the JAK2 V617F mutation, suggesting an association with a myeloproliferative disorder.
References
[1]
Chavez, A. and Pougnier, C. (2021) A Case of COVID-19 Vaccine Associated New Diagnosis Myasthenia Gravis. JournalofPrimaryCare&CommunityHealth, 12. https://doi.org/10.1177/21501327211051933
[2]
Lee, M.A., Lee, C., Park, J.H. and Lee, J.H. (2022) Early-onset Myasthenia Gravis Following COVID-19 Vaccination. JournalofKoreanMedicalScience, 37, e50. https://doi.org/10.3346/jkms.2022.37.e50
[3]
Barzilai, O., Ram, M. and Shoenfeld, Y. (2007) Viral Infection Can Induce the Production of Autoantibodies. CurrentOpinioninRheumatology, 19, 636-643. https://doi.org/10.1097/bor.0b013e3282f0ad25
[4]
Ramdas, S., Hum, R.M., Price, A., Paul, A., Bland, J., Burke, G., et al. (2022) SARS-CoV-2 Vaccination and New-Onset Myasthenia Gravis: A Report of 7 Cases and Review of the Literature. NeuromuscularDisorders, 32, 785-789. https://doi.org/10.1016/j.nmd.2022.09.001
[5]
Slavin, E., Fitzig, J., Neubert, C., Garcia-Lopez, F. and Cuevas-Trisan, R. (2022) New-onset Myasthenia Gravis Confirmed by Electrodiagnostic Studies after a Third Dose of SARS-CoV-2 mRNA-1273 Vaccine: A Case Report. AmericanJournalofPhysicalMedicine&Rehabilitation, 101, e176-e179. https://doi.org/10.1097/phm.0000000000002076
[6]
Vadalà, M., Poddighe, D., Laurino, C. and Palmieri, B. (2017) Vaccination and Autoimmune Diseases: Is Prevention of Adverse Health Effects on the Horizon? EPMAJournal, 8, 295-311. https://doi.org/10.1007/s13167-017-0101-y
[7]
Finsterer, J. (2021) Neurological Side Effects of SARS-CoV-2 Vaccinations. ActaNeurologicaScandinavica, 145, 5-9. https://doi.org/10.1111/ane.13550
[8]
Abna, Z., Khanmoradi, Z. and Abna, Z. (2022) A New Case of Myasthenia Gravis Following COVID-19 Vaccination. Neuroimmunology Reports, 2, Article ID: 100128. https://doi.org/10.1016/j.nerep.2022.100128
[9]
Mungmunpuntipantip, R. and Wiwanitkit, V. (2022) Acute Onset Ocular Myasthenia Gravis after COVID-19 Vaccination: Correspondence. Orbit, 41, 661-661. https://doi.org/10.1080/01676830.2022.2079677
[10]
Maher, D.I., Hogarty, D. and Ben Artsi, E. (2022) Response to Letter to the Editor Regarding “Acute Onset Ocular Myasthenia Gravis after Vaccination with the Oxford-Astrazeneca COVID-19 Vaccine”. Orbit, 41, 662-663. https://doi.org/10.1080/01676830.2022.2087234
[11]
Galassi, G., Rispoli, V., Iori, E., Ariatti, A. and Marchioni, A. (2022) Coincidental Onset of Ocular Myasthenia Gravis Following ChAdOx1 n-CoV-19 Vaccine against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The Israel Medical Association Journal, 24, 9-10.
[12]
Watad, A., De Marco, G., Mahajna, H., Druyan, A., Eltity, M., Hijazi, N., et al. (2021) Immune-mediated Disease Flares or New-Onset Disease in 27 Subjects Following mRNA/DNA SARS-CoV-2 Vaccination. Vaccines, 9, Article 435. https://doi.org/10.3390/vaccines9050435
[13]
Hoshina, Y., Sowers, C. and Baker, V. (2022) Myasthenia Gravis Presenting after Administration of the mRNA-1273 Vaccine. EuropeanJournalofCaseReportsinInternalMedicine, 9, Article ID: 003439. https://doi.org/10.12890/2022_003439
[14]
Fanella, G., Baiata, C., Candeloro, E., Toscano, G., Colnaghi, S., Mauri, M., et al. (2022) New-Onset Myasthenia Gravis after mRNA SARS-CoV-2 Vaccination: A Case Series. NeurologicalSciences, 43, 5799-5802. https://doi.org/10.1007/s10072-022-06284-5
[15]
Kang, M.C., Park, K., Min, J. and Oh, S.Y. (2022) Myasthenia Gravis with Ocular Symptoms Following a ChAdOx1 nCoV-19 Vaccination: A Case Report. AmericanJournalofOphthalmologyCaseReports, 27, Article ID: 101620. https://doi.org/10.1016/j.ajoc.2022.101620
[16]
Sasi, S., Mohamed, M. and Yassin, M.A. (2022) Myasthenia Gravis and Myeloproliferative Neoplasms—Mere Association or Paraneoplastic Neurologic Syndrome: A Mini-Review. Acta Biomedica, 92, e2021437. https://doi.org/10.22541/au.161525501.12600394/v1
[17]
Sasi, S., Yassin, M.A., Kamran, S. and Mnatsakanyan, V. (2020) Association of Polycythemia Vera with Positive JAK2V617F Mutation and Myasthenia Gravis: A Report of Two Cases. ClinicalCaseReports, 9, 531-534. https://doi.org/10.1002/ccr3.3574
