Case Report: Anti-NF186+ CIDP After Receiving the Inactivated Vaccine for Coronavirus Disease (COVID-19)

Abstract

Corona Virus Disease 2019 (COVID-19), the novel coronavirus disease, is now a global pandemic. Vaccination can significantly reduce the mortality rate caused by the severe acute respiratory syndrome of coronavirus 2 (SARS-CoV-2). There are currently several effective vaccines that have been introduced. Inactivated COVID-19 vaccine is one of these options and is generally considered safe. Neurofascin (NF) plays an important role in keeping the functionality of the node of Ranvier. We report here a rare case of anti-NF186+ chronic inflammatory demyelinating polyneuropathy (CIDP) in a 23-year-old male patient who was vaccinated with inactivated COVID-19 vaccine prior to the onset. This report adds a new possible rare side effect of a COVID-19 vaccine and provides a case for the clinical effectiveness of rituximab (RTX) in patients with anti-NF186+ CIDP.

COVID-19 vaccination hesitancy and safety among adult people with epilepsy in eastern China

“…It is well established that PWE have a higher cumulative COVID-19 incidence rate and a higher risk of mortality compared to the general population [2] . A mass immunization program is considered the best method of slowing the pandemic, and the COVID-19 vaccine is safe for the vast majority of people [3] , [4] , [5] , [6] , though there are some post-vaccination cases of demyelinating diseases, cerebral venous sinus thrombosis, and seizures among healthy people without epilepsy [7] , [8] , [9] . While there are a limited number of PWE in studies with COVID-19 vaccines [4] , [5] , [10] , [11] , [12] and a lack of emphasis on seizure worsening, the International League Against Epilepsy (ILAE) still recommended that PWE should get vaccinated.…”

Case report: Anti-CNTN1 antibody-associated nodopathies disease with asymmetric onset

“…Antecedent infections or vaccinations may also be a trigger for autoimmune nodopathies. In 2022, a NF186+ autoimmune nodopathies case was reported following COVID-19 vaccination ( 11 ). Some studies suggest ( 12 , 13 ) that this may be a result of interactions between the susceptible vaccinated subject and various vaccine components.…”

Pan-Neurofascin autoimmune nodopathy – a life-threatening, but reversible neuropathy

“…Seropositive patients present with distinct symptoms such as acute onset, moderate to severe sensorimotor involvement, and additional features such as severe sensory ataxia, tremor, neuropathic pain, or concomitant glomerulonephritis in case of contactin-1 [2,6 ▪▪ ,11 ▪ ,12]. In contrast, antibodies against nodal NF186 were reported with heterogenous clinical presentation, from immune-mediated neuropathies to central nervous system disease [9,13–17]. Large CIDP cohorts, on the contrary, were screened negative for NF186 [18,19].…”