RESUMO
As COVID-19 vaccination becomes widely available and administered globally, there have been several reports of side effects attributed to the vaccine. This report highlights a patient who developed stroke 2 days following the administration of the COVID-19 vaccine, although its association remains uncertain. A man in his late 30s developed acute neurological symptoms 2 days after receiving the booster dose of the BNT162b2 (Pfizer-BioNTech) mRNA COVID-19 vaccine. History and neurological examination suggested a posterior circulation stroke, which was confirmed by MRI, as a right-sided posterior inferior cerebellar artery stroke. Full workup did not suggest other causes of the stroke. Due to the patient's age and well-controlled risk factors, it was presumed to be a rare adverse effect of the vaccine. Medical management with aspirin, statin therapy and rehabilitation led to the improvement of symptoms and enabled ongoing restoration of function. Further cases of stroke following administration of COVID-19 vaccine have been documented in the literature, but the association is yet to be established.
Assuntos
Infartos do Tronco Encefálico , COVID-19 , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Acidente Vascular Cerebral , Masculino , Humanos , Vacinas contra COVID-19/efeitos adversos , Vacina BNT162 , COVID-19/prevenção & controle , Acidente Vascular Cerebral/etiologiaRESUMO
This case report describes an 84-year-old man who presented with 3 weeks of gradually worsening right arm weakness associated with a painful vesicular rash across his arm. This occurred 3 days after his first dose of the ChAdOx1 nCoV-19/AZD1222 (University of Oxford, AstraZeneca and the Serum Institute of India) vaccine. The diagnosis was complicated by the presence of right C5-C6 foraminal stenosis compressing on the C6 nerve root sheath on non-contrast MRI, leading to an initial diagnosis of cervical radiculopathy. However, a positive varicella zoster virus-PCR test and findings of abnormal contrast enhancement of his right C5-C7 nerve roots on gadolinium-enhanced MRI resulted in a revision of his diagnosis to zoster radiculopathy. He was subsequently commenced on oral valacilovir and made significant recovery. This report aims to highlight the diagnostic dilemma between cervical radiculopathy secondary to spondylosis and zoster radiculopathy and how an erroneous diagnosis could result in inappropriate, aggressive surgical intervention and delayed treatment with antiviral therapy.
Assuntos
Herpes Zoster , Radiculopatia , Idoso de 80 Anos ou mais , ChAdOx1 nCoV-19 , Herpes Zoster/complicações , Herpes Zoster/diagnóstico , Herpes Zoster/tratamento farmacológico , Herpesvirus Humano 3 , Humanos , Masculino , Radiculopatia/complicações , Radiculopatia/etiologia , Vacinação/efeitos adversosRESUMO
Antitumour necrosis factor alpha agents are important treatments in many inflammatory conditions including rheumatoid arthritis, psoriatic arthritis and the inflammatory bowel diseases. However, there have been case reports of optic neuritis and other demyelinating diseases as complications of these agents. This case report presents a patient with ulcerative colitis on infliximab who presented with sudden onset mono-ocular visual field loss and highlights the diagnosis and management of infliximab-induced optic neuritis.
Assuntos
Cegueira/imunologia , Colite Ulcerativa/tratamento farmacológico , Fármacos Gastrointestinais/efeitos adversos , Infliximab/efeitos adversos , Neurite Óptica/imunologia , Anticorpos Monoclonais Humanizados/uso terapêutico , Cegueira/diagnóstico , Cegueira/tratamento farmacológico , Colite Ulcerativa/imunologia , Substituição de Medicamentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Nervo Óptico/diagnóstico por imagem , Nervo Óptico/efeitos dos fármacos , Nervo Óptico/imunologia , Neurite Óptica/complicações , Neurite Óptica/diagnóstico , Neurite Óptica/tratamento farmacológico , Prednisolona/uso terapêutico , Tomografia de Coerência Óptica , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Fator de Necrose Tumoral alfa/imunologia , Acuidade Visual , Testes de Campo Visual , Campos VisuaisRESUMO
The exact epidemiology of autoimmune bullous disorders in Australia is unknown. This article describes the establishment of a registry and support group to serve patients with these disorders. The registry aids research in Australia by providing epidemiologic data and maintaining an up-to-date database with patient contact details. The support group caters to the needs of patients and/or caregivers. Teledermatology, diagnosis, and management of autoimmune bullous disease are briefly reviewed.
