A case report of possible concurrent vasculitis in vertebral bodies and partial transverse myelitis following COVID-19 vaccination

Abstract

Introduction: Cases with organ-specific and systemic vasculitis associated with corona virus disease 2019 (COVID-19) vaccination have been reported. However, acute partial transverse myelitis (APTM) is rare adverse events following received COVID-19 vaccines. To the best of our knowledge, there is no report on vaccine-associated APTM accompanied by possible concurrent vasculitis. Herein we present a case with possible concurrent spinal vasculitis and APTM following the second dose of inactivated COVID-19 vaccine. Case summary: A 33-year-old man presented with weakness of left lower limb and aberrant sensation of his left lower trunk and limb (from T9 level to toes) for 2 days following receipt of an inactivated COVID-19 vaccine. Remarkable demyelinating lesion at T7 spinal cord was showed by 3.0T magnetic resonance imaging (MRI) scan. Moreover, vertebral bodies of T3-T7 also presented high signal in T-2 weighted imaging (T2WI) accompanied by multiple sites of flowing void effect indicating possible vasculitis. Oligoclonal band was positive in cerebrospinal fluid (CSF) while it was negative in sera. Intravenous methylprednisolone (1 g/d) was administrated for 5 days followed by subsequent dose-tapering prednisone. His limb weakness and aberrant sensation both improved and he was able to walk unaided after treatment. The MRI recheck also showed remarkable improvement on the lesions in spinal cord and vertebral bodies. Conclusion: this case illustrates the concurrence of possible vasculitis in vertebral bodies and acute transverse myelitis (ATM) following COVID-19 vaccination.

Post-COVID-19 Vaccination CNS Magnetic Resonance Imaging Findings: A Systematic Review

“…Hirose et al [ 57 ] and Eom et al [ 58 ] described cases of ATM following mRNA-1273 (Moderna) and Pfizer-BioNTech vaccination, respectively. Alabkal et al [ 59 ] reported a case of TM following the Pfizer-BioNTech vaccine, while Chen et al [ 60 ] described a concurrent vasculitis in vertebral bodies and partial TM in a patient whose vaccine type was not specified. These cases add further evidence to the potential association between COVID-19 vaccination and the development of ATM or TM.…”