SHM Converge Scientific Abstract ePoster Gallery-Subacute Onset of Guillain Barre Syndrome Post Mrna-1273 Vaccination

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This case report describes a 49-year-old woman with hypertension and bipolar disorder who developed subacute Guillain-Barré syndrome (GBS) after receiving the first dose of the Moderna mRNA-1273 COVID-19 vaccine. Her symptoms began 10 days after vaccination with weakness in both feet that gradually ascended to involve the legs, waist, and upper extremities over 8 weeks. On examination, she had marked limb weakness, reduced sensation, and absent deep tendon reflexes.<br /><br />Cerebrospinal fluid analysis showed albuminocytologic dissociation, supporting an immune-mediated polyneuropathy diagnosis. MRI of the cervical, thoracic, and lumbar spine showed no myelopathy, and SARS-CoV-2 testing was negative. Her condition worsened soon after admission, with declining respiratory function and reduced forced vital capacity, requiring intubation and ventilatory support. She was treated with plasma exchange and later improved enough to be extubated. Her hospital course was also complicated by hypotension, which was managed with midodrine. She was ultimately discharged to a rehabilitation facility.<br /><br />The report notes that GBS has been increasingly reported after COVID-19 vaccination, especially with adenoviral vector vaccines, while cases after mRNA vaccines are rarer. The prolonged, “subacute” course in this patient was atypical for classic GBS and raised the possibility of chronic inflammatory demyelinating polyneuropathy (CIDP), but the abrupt onset after vaccination, autonomic dysfunction, and need for respiratory support favored GBS. The authors conclude that this may be the first known report of subacute GBS after mRNA-1273 vaccination, but emphasize that a causal relationship has not been established and further surveillance and study are needed.

Asset Subtitle

Shivaraj Nagalli

Meta Tag

Author List Nidhi Kikkeri, Shivaraj Nagalli

Category Clinical Vignettes

Concept Guillain-Barré Syndrome

Concept Areflexia

Concept Progressive Weakness

Concept Albuminocytologic Dissociation

Concept Chronic Inflammatory Demyelinating Polyradiculoneuropathy

Distinguished Non-Finalist

Presenter Organization Brookwood Baptist Health

Presenting Author Shivaraj Nagalli

Track Adult

Keywords

Guillain-Barré syndrome

mRNA-1273

Moderna COVID-19 vaccine

subacute polyneuropathy

albuminocytologic dissociation

ascending weakness

plasma exchange

respiratory failure

CIDP differential diagnosis

vaccination adverse event

Guillain-Barré Syndrome

Areflexia

Progressive Weakness

Albuminocytologic Dissociation

Chronic Inflammatory Demyelinating Polyradiculoneuropathy