Case Series: Acute Hemorrhagic Encephalomyelitis After SARS-CoV-2 Vaccination

Mihai Ancau; Friederike Liesche-Starnecker; Johanna Niederschweiberer; Sandro M. Krieg; Claus Zimmer; Charlotte Lingg; Daniela Kumpfmüller; Benno Ikenberg; Markus Ploner; Bernhard Hemmer; Bernhard Hemmer; Silke Wunderlich; Mark Mühlau; Benjamin Knier

doi:10.3389/fneur.2021.820049

Frontiers in Neurology (Feb 2022)

Case Series: Acute Hemorrhagic Encephalomyelitis After SARS-CoV-2 Vaccination

Mihai Ancau,
Friederike Liesche-Starnecker,
Johanna Niederschweiberer,
Sandro M. Krieg,
Claus Zimmer,
Charlotte Lingg,
Daniela Kumpfmüller,
Benno Ikenberg,
Markus Ploner,
Bernhard Hemmer,
Bernhard Hemmer,
Silke Wunderlich,
Mark Mühlau,
Benjamin Knier

Affiliations

Mihai Ancau: Department of Neurology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
Friederike Liesche-Starnecker: Department of Neuropathology, Institute of Pathology, Technical University of Munich, Munich, Germany
Johanna Niederschweiberer: Department of Neurology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
Sandro M. Krieg: Department of Neurosurgery, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
Claus Zimmer: Department of Neuroradiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
Charlotte Lingg: Department of Anesthesiology and Intensive Care Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
Daniela Kumpfmüller: Department of Anesthesiology and Intensive Care Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
Benno Ikenberg: Department of Neurology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
Markus Ploner: Department of Neurology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
Bernhard Hemmer: Department of Neurology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
Bernhard Hemmer: Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
Silke Wunderlich: Department of Neurology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
Mark Mühlau: Department of Neurology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
Benjamin Knier: Department of Neurology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany

DOI: https://doi.org/10.3389/fneur.2021.820049
Journal volume & issue: Vol. 12

Abstract

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We present three cases fulfilling diagnostic criteria of hemorrhagic variants of acute disseminated encephalomyelitis (acute hemorrhagic encephalomyelitis, AHEM) occurring within 9 days after the first shot of ChAdOx1 nCoV-19. AHEM was diagnosed using magnetic resonance imaging, cerebrospinal fluid analysis and brain biopsy in one case. The close temporal association with the vaccination, the immune-related nature of the disease as well as the lack of other canonical precipitating factors suggested that AHEM was a vaccine-related adverse effect. We believe that AHEM might reflect a novel COVID-19 vaccine-related adverse event for which physicians should be vigilant and sensitized.

Published in Frontiers in Neurology

ISSN: 1664-2295 (Online)
Publisher: Frontiers Media S.A.
Country of publisher: Switzerland
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry: Neurology. Diseases of the nervous system
Website: https://www.frontiersin.org/journals/neurology/

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