Page 88 - GPD-2-3

Gene & Protein in Disease

CASE REPORT
Multisystem inflammatory syndrome in adult

with longitudinally extensive transverse myelitis
following SARS-CoV-2 vaccination: A case report

Anirban Gupta *, Sudheer Pandey , Pawan Dhull , Amit Sreen , Satish Barki ,
1
1
1
1
1
Krishna Kumar , and Kompella Kiran Kumar 3
2
1 Department of Neurology, Army Hospital (R&R), New Delhi, India
2 Department of Anesthesia and Critical Care, Army Hospital (R&R), New Delhi, India
3 Department of Internal Medicine, Army Hospital (R&R), New Delhi, India

Abstract
Multisystem inflammatory syndrome in adults (MIS-A) is a known complication
arising after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection
or vaccination. However, longitudinal extensive transverse myelitis (LETM), which
is a neurological manifestation of MIS-A, is rarely reported among individuals after
SARS-CoV-2 infection or vaccination. Here, we present a case of a 38-year-old female,
with a history of SARS-CoV-2 infection in May 2021 and subsequent SARS-CoV-2
vaccination (on November 1, 2021; COVISHIELD™, ChAdOx1 nCoV-19 Corona Virus
Vaccine), who presented with acute flaccid quadriparesis with bowel and bladder
involvement since December 26, 2021. While being treated in the hospital, she
developed fever, rash, shock, myocarditis, breathlessness, jaundice, and acute kidney
*Corresponding author: injury. Magnetic resonance Imaging revealed LETM. She was negative for SARS-CoV-2
Anirban Gupta
(dranirban1974@gmail.com) infection and showed raised in SARS-CoV-2 antibody titer. Thus, she was diagnosed
as having MIS-A with LETM and managed with Intravenous Immunoglobulin,
Citation: Gupta A, Pandey S, antibiotics, hemodialysis, and steroids with improvement.
Dhull P, et al., 2023, Multisystem
inflammatory syndrome in adult with
longitudinally extensive transverse
myelitis following SARS-CoV-2 Keywords: Severe acute respiratory syndrome coronavirus 2; Multisystem inflammatory
vaccination: A case report. Gene syndrome in adults; Vaccination; Flaccid quadriparesis; Longitudinal extensive
Protein Dis, 2(3): 1320. transverse myelitis
https://doi.org/10.36922/gpd.1320
Received: July 18, 2023
Accepted: September 5, 2023
Published Online: September 29,
2023 1. Background
Copyright: © 2023 Author(s). Multisystem inflammatory syndrome shares an inexplicable link with severe acute
This is an Open-Access article respiratory syndrome coronavirus 2 (SARS-CoV-2). Multisystem inflammatory
distributed under the terms of the
Creative Commons Attribution syndrome in children (MIS-C) following SARS-CoV-2 infection was first described in
License, permitting distribution, and May 2020 [1,2] , whereas the first case of multisystem inflammatory syndrome in adults
reproduction in any medium, which (MIS-A) following SARS-CoV-2 infection was described in October 2020 .
[3]
provided that the original work is
properly cited. The invention of a viable SARS-CoV-2 vaccine was first announced in December
Publisher’s Note: AccScience 2020, marking a monumental milestone in our battle against SARS-CoV-2 infection,
Publishing remains neutral with and following that, a series of vaccines developed in the USA, the UK, Russia, India, and
regard to jurisdictional claims in
published maps and institutional China were rolled out, whose ability in conferring protective immunity had been clinically
™
affiliations. tested. COVISHIELD , ChAdOx1 nCoV-19 Corona Virus Vaccine is one of the principal

Volume 2 Issue 3 (2023) 1 https://doi.org/10.36922/gpd.1320