A Rare Case of Longitudinally Extensive Transverse Myelitis Following Pfizer-BioNTech COVID-19 Vaccination with a Favourable Outcome

Ojbindra Kc; Punya Hari Dahal; Manisha Koirala; Sumeet Kumar Yadav

doi:10.12890/2022_003553

A Rare Case of Longitudinally Extensive Transverse Myelitis Following Pfizer-BioNTech COVID-19 Vaccination with a Favourable Outcome

Eur J Case Rep Intern Med. 2022 Sep 15;9(9):003553. doi: 10.12890/2022_003553. eCollection 2022.

Authors

Ojbindra Kc¹, Punya Hari Dahal¹, Manisha Koirala¹, Sumeet Kumar Yadav²

Affiliations

¹ Department of Hospital Medicine, Faith Regional Health Services, Norfolk, Nebraska, USA.
² Department of Hospital Medicine, Mayo Clinic Health System, Mankato, Minnesota, USA.

Abstract

Introduction: mRNA COVID-19 vaccines are very safe, but rare adverse events such as transverse myelitis have been reported after COVID-19 vaccination.

Case description: We report the case of 50-year-old man who presented with progressive lower extremity weakness, back pain and urinary retention after his second dose of the Pfizer COVID-19 vaccine. MRI of the spine revealed longitudinally extensive transverse myelitis (LETM). He recovered completely after treatment with intravenous methylprednisone and physical therapy.

Discussion: This case highlights the rare association between LETM and COVID-19 vaccines and encourages clinicians to maintain a high index of suspicion for prompt diagnosis and treatment.

Learning points: Longitudinally extensive transverse myelitis (LETM) is rare adverse events after mRNA COVID-19 vaccination.Clinicians should maintain a high index of suspicion for prompt diagnosis of vaccine-induced transverse myelitis.Vaccine-induced LETM should show marked clinical improvement after appropriate treatment.

Keywords: COVID-19; autoimmune disease; mRNA COVID-19 vaccines; transverse myelitis.