Acute hemorrhagic leukoencephalitis following the first dose of BNT162b2 vaccine against SARS-CoV-2: A case report.

Autor:	Kalafatakis K; Department of Neurology, 417 Army Share Fund Hospital, Athens, Greece.; Faculty of Medicine & Dentistry (Malta Campus), Queen Mary University of London, Victoria, Malta., Margoni A; Department of Neurology, 417 Army Share Fund Hospital, Athens, Greece., Liakou ME; Department of Neurology, 417 Army Share Fund Hospital, Athens, Greece., Stenos C; Department of Neurology, 417 Army Share Fund Hospital, Athens, Greece., Toulas P; Research Unit of Radiology, Second Department of Radiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece., Korkolopoulou P; First Department of Pathology, LAIKON University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece., Lakiotaki E; First Department of Pathology, LAIKON University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece., Lafazanos SA; Department of Neurosurgery, 417 Army Share Fund Hospital, Athens, Greece., Zekiou K; Department of Neurology, 417 Army Share Fund Hospital, Athens, Greece., Kardara P; Department of Neurology, 417 Army Share Fund Hospital, Athens, Greece., Terentiou A; Department of Neurology, 417 Army Share Fund Hospital, Athens, Greece., Nikolaou G; Department of Neurology, 417 Army Share Fund Hospital, Athens, Greece., Stouraitis G; Department of Neurology, 417 Army Share Fund Hospital, Athens, Greece.
Jazyk:	angličtina
Zdroj:	Heliyon [Heliyon] 2024 Feb 02; Vol. 10 (3), pp. e25545. Date of Electronic Publication: 2024 Feb 02 (Print Publication: 2024).
DOI:	10.1016/j.heliyon.2024.e25545
Abstrakt:	Acute hemorrhagic leukoencephalitis (AHLE), is a rare inflammatory demyelinating disorder, variant of acute disseminated encephalomyelitis. The diagnosis of AHLE remains challenging due to the rarity of the disease and the lack of a reliable biomarker. We report here a case of a 73-year-old male patient with a progressive, low-grade febrile confusional syndrome 20 days after receiving the first dose of BNT162b2 vaccine against SARS-CoV-2. Evidence indicative of the underlying condition by an extensive panel of imaging (brain magnetic resonance imaging, computed tomography and digital subtraction angiography), laboratory (complete blood count, biochemistry, coagulation, tests for autoimmune or infectious disorders, tumor markers, hormonal levels, cerebrospinal fluid analysis) and electrodiagnostic tests were scarce, and mainly non-specific. Sequential neuroimaging revealed the appearance of extensive T2 lesions (signs of gliosis) along with multiple hemorrhagic lesions at various cortical sites. The patient was treated with corticosteroids, discontinued due to severe adverse effects, and subsequently with sessions of plasmapheresis and monthly intravenous administration of cyclophosphamide. Considering the rapid aggravation of the patient's neurological status, the MRI findings of cortical lesions and the lack of response to any treatment, a biopsy of a frontal lobe lesion was conducted, confirming the presence of confluent, inflammatory-edematous lesions with scattered areas of necrosis and hemorrhage, and ultimately areas of demyelination, thus confirming the diagnosis of AHLE. After more than 5 months of hospitalization the patient was transferred in a primary care facility and remained in a permanent vegetative state until his death, more than 2 years later. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2024 The Authors.)
Databáze:	MEDLINE
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