Detection of anti-NMDA receptor antibodies following BBIBP-CorV COVID-19 vaccination in a rituximab-treated person with multiple sclerosis presenting with manifestations of an acute relapse

Etemadifar, Masoud; Nouri, Hosein; Salari, Mehri; Sedaghat, Nahad

doi:10.1080/21645515.2022.2033540

Cited by 11 publications

(8 citation statements)

References 18 publications

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“…Some studies included demyelinating diseases, GBS, and anti-NMDAR encephalitis. Demyelinating diseases, particularly multiple sclerosis (MS) and clinically isolated demyelinating syndrome, were observed in several cases [ 65 , 66 ]. The majority of these patients had a history of MS or other demyelinating disorders, suggesting that the COVID-19 vaccination might have induced an exacerbation of the pre-existing condition.…”

Section: Discussionmentioning

confidence: 99%

“…One case reported by Etemadifar et al [ 65 ] described a patient who developed anti-NMDAR encephalitis, an autoimmune disorder, after receiving the Sinopharm BIBP-CorV vaccine. The patient presented with various symptoms, including myalgia, ataxia, and dizziness, and the MRI findings revealed multiple new plaques in the periventricular, juxtacortical, and cortical areas.…”

Section: Discussionmentioning

confidence: 99%

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

Ghaderi

Mohammadi

Heidari

et al. 2023

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Objective. This systematic review aims to synthesize and analyze the available literature on central nervous system (CNS) magnetic resonance imaging (MRI) findings in individuals who have received COVID-19 vaccinations. Our objective is to enhance understanding of potential neurological side effects, inform clinical practice, and guide future research on the neurological implications of COVID-19 vaccination. Methods. In this systematic review, we conducted a comprehensive search in PubMed, Scopus, and Web of Science from January 2020 to April 2023, using terms related to COVID-19 vaccination and CNS MRI findings. We evaluated the quality of the study, extracted relevant data, and included 89 eligible studies that covered various vaccines, demographics of patients, symptoms, and MRI findings to provide a thorough understanding of SARS-CoV-2 vaccination-related CNS problems. Results. We investigated CNS MRI findings following COVID-19 vaccination across various vaccine types. Common diseases associated with post-vaccination CNS MRI findings included cerebral venous sinus thrombosis (CVST), vaccine-induced immune thrombotic thrombocytopenia (VITT), acute disseminated encephalomyelitis (ADEM), acute myelitis, autoimmune encephalitis (AE), and others. Patients presented with diverse onset symptoms and neurological manifestations. Abnormalities identified in CNS MRI findings included white matter (WM) hyperintensity. Our analysis offers a comprehensive overview of the current literature on post-vaccination CNS MRI findings. Discussion. We highlight a range of post-COVID-19 vaccination CNS MRI findings, including CVST, with a higher incidence in individuals receiving the ChAdOx1 (AstraZeneca) vaccine. Other notable observations include cases of ADEM, myelitis or transverse myelitis (TM), Guillain–Barré syndrome (GBS), and acute encephalopathy following COVID-19 vaccination. The incidence of these neurological complications is extremely rare, and the benefits of vaccination outweigh the risks. The reviewed studies were primarily case reports or case series, and thus large-scale epidemiological studies and controlled clinical trials are needed to better understand the underlying mechanisms and risk factors associated with these neurological complications following COVID-19 vaccination.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Ghaderi

Mohammadi

Heidari

et al. 2023

Canadian Journal of Infectious Diseases and Medical Microbiolog

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“…A further publication reported the case of a 50-year old woman with a history of multiple sclerosis who presented a deterioration of neurological symptoms, with detection of anti-NMDAR antibodies in the serum. Two weeks previously, the patient had received the second dose of BBVIP-CorV vaccine (inactivated) ( Etemadifar et al, 2022 ). Four cases of anti-NMDAR encephalitis were identified in VigiBase involving COVID-19 vaccines, all mRNA vaccines.…”

Section: Discussionmentioning

confidence: 99%

Anti-NMDA receptor encephalitis and vaccination: A disproportionality analysis

et al. 2022

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Anti–N-methyl-D-aspartate receptor (NMDAR) encephalitis is an auto-immune neurological disorder characterized by the presence in the cerebrospinal fluid (CSF) of antibodies against the GluN1 subunit of NMDA receptors in the brain. The etiology of the disease remains largely unknown. In this study, we aimed to investigate the possible existence of pharmacovigilance signals relating to a link between vaccination and the occurrence of anti-NMDAR encephalitis. We performed a case/non-case study using data from the World Health Organization pharmacovigilance database (VigiBase) up to 31 December 2021. All individual case study reports (ICSRs) linked to a vaccine and coded with the MedDRA Lower Level Term (LLT) “anti-NMDA receptor encephalitis” were analysed. We calculated the Reporting Odds Ratio (ROR) and 95% Confidence Interval (CI) for each type of vaccine. A total of 29,758,737 ICSRs were registered in VigiBase, of which 70 were coded under the selected LLT, and 29/70 (41.4%) involved a vaccine. Of these cases, 53.8% involved children aged younger than 15 years. The median time to onset of anti-NMDAR encephalitis after vaccination was 4 days (range 0–730). The highest RORs were observed for the diphtheria/polio/tetanus/pertussis vaccine [54.72 (95% CI 26.2–114.3)], yellow fever vaccine [50.02 (95% CI 15.7–159)] and human papillomavirus vaccine [32.89 (15.8–68.7)]. All cases were coded as serious; 13 patients did not recover, or were left with permanent sequelae. Nine patients recovered without sequelae or are on the path to recovery, and one patient died. In summary, pharmacovigilance signals were observed for anti-NMDAR encephalitis and vaccination. Clinicians need to be aware of this potential risk, and encourage to report any case of anti-NMDAR encephalitis occurring after vaccination.

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“…There are also symptoms of withdrawal from social life and stereotyped behavior that appear within a few days (mean 5 days, generally less than 2 weeks). In children, the symptoms of psychosis are less dominant, while the symptoms of speech disorders are quite often found (Kim et al, 2021;Etemadifar et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Other mental disorders YDT due to brain damage and dysfunction and physical disease in patients with anti-NMDA encephalitis

Wardana

Ardani²,

Aryani³

et al. 2022

ijhms

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Autoimmune encephalitis (AIE) is considered one of the most common causes of acute noninfectious encephalitis. Autoimmune encephalitis is usually of acute or subacute onset and may become chronic later. Suggested mechanisms that may trigger AIE include tumor (paraneoplastic), infection (parainfection) or may be cryptogenic. Autoimmune encephalitis has a wide range of clinical manifestations including behavioral and psychiatric symptoms, autonomic disorders, movement disorders and seizures. In this Case Report 13 year old boy, Hindu, Balinese, currently attending junior high school, unmarried, student. The patient was consulted to the psychiatry department while in the Cempaka room because he looked restless and confused. The patient experienced mood swings in the form of an unstable mood, accompanied by irritability, difficulty calming down, feeling uncomfortable, disturbed sleep, and decreased appetite after the patient underwent treatment at the hospital since last February. On physical examination, physical status was found within normal limits, nutritional status was good, and general status was within normal limits. Examination of psychiatric status found an unnatural appearance that looked confused and uncomfortable, verbal and visual contact was lacking, clear consciousness, mood and affect were labile, in thought processes there was preoccupation with the disease, in perception there were visual hallucinations.

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Detection of anti-NMDA receptor antibodies following BBIBP-CorV COVID-19 vaccination in a rituximab-treated person with multiple sclerosis presenting with manifestations of an acute relapse

Cited by 11 publications

References 18 publications

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

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

Anti-NMDA receptor encephalitis and vaccination: A disproportionality analysis

Other mental disorders YDT due to brain damage and dysfunction and physical disease in patients with anti-NMDA encephalitis

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