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This case study details Parsonage-Turner syndrome (PTS) following post-exposure prophylaxis (PEP) for HIV and HBV. It highlights a rare but distinct disorder triggered by immunological events like vaccination.

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Area of Science:

  • Neurology
  • Immunology
  • Vaccinology

Background:

  • Parsonage-Turner syndrome (PTS) is a rare neurological disorder characterized by acute shoulder pain, followed by muscle weakness and atrophy.
  • The exact pathophysiology of PTS is not fully understood but involves genetic, mechanical, and autoimmune factors.
  • This report describes the first known case of PTS following post-exposure prophylaxis (PEP) for potential HIV and HBV infection.

Observation:

  • A 25-year-old man developed unilateral scapular winging and shoulder pain after receiving PEP.
  • Neurological examination, radiography, and EMG revealed no other abnormalities, despite supraspinatus muscle atrophy and weakness.
  • The patient was diagnosed with post-vaccination PTS and managed non-operatively.

Findings:

  • The patient experienced symptom resolution, including receding scapular winging and regained muscle strength over 15 months.
  • While PTS diagnosis lacks definitive tests, clinical presentation and exclusion of other disorders are key.
  • Vaccinations, as part of PEP, can act as an immunological trigger for PTS onset.

Implications:

  • This case expands the known triggers for PTS, linking it to PEP vaccination.
  • Understanding immunological triggers like vaccination is crucial for diagnosing and managing PTS.
  • While recovery is often favorable, residual impairment can occur, emphasizing the need for continued research into treatment and prevention.