Amyloid β-related angiitis of the central nervous system occurring after COVID-19 vaccination: A case report

World J Clin Cases. 2022 Dec 6;10(34):12617-12622. doi: 10.12998/wjcc.v10.i34.12617.

Abstract

Background: Although coronavirus disease 2019 (COVID-19) vaccines have been effective in controlling the COVID-19 pandemic, a variety of post-vaccination neurological complications have been reported worldwide. Amyloid β-related angiitis (ABRA) is a rare neurological disease. The underlying cause of ABRA is unknown, but several studies suggest that it is caused by an excessive immune response to amyloid-β deposited in blood vessels. In addition, limited attention has been paid to potential triggers of ABRA, such as infection or vaccination.

Case summary: We report a case of ABRA that developed 2 wk after COVID-19 vaccination. A 75-year-old woman developed a frontal headache after receiving a second dose of COVID-19 BNT162b2 vaccine (Pfizer-BioNTech). Diffusion-weighted magnetic resonance imaging (DW-MRI) of the head showed abnormal hyperintensity, suggesting cerebral infarctions in the left parietal and occipital lobes. We diagnosed her condition as ABRA based on a brain biopsy. We administered steroid pulse therapy and the patient's symptoms and DW-MRI abnormalities improved. This case had a good outcome due to prompt diagnosis and treatment.

Conclusion: We report a case of ABRA that may have been triggered by COVID-19 vaccination.

Keywords: Amyloid β-related angiitis; COVID-19; Case report; Neurological complications; Vaccination.

Publication types

  • Case Reports