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Anti-GAD Encephalitis Following COVID-19 Vaccination: A Case Report
Çiğdem Deniz1, Bengü Altunan1, Aysun Ünal1
1Department of Neurology, Tekirdağ Namık Kemal University, Tekirdağ, Turkey.
Insights
COVID-19 vaccination may rarely trigger anti-GAD antibody positive autoimmune encephalitis. Early diagnosis and treatment of this rare neurological side effect offer a good prognosis for patients.
Area of Science:
- Neurology
- Immunology
- Vaccinology
Background:
- Widespread COVID-19 vaccination since December 2020.
- Reported neurological complications post-vaccination, causality unproven.
- Autoimmune encephalitis as a potential vaccine-related adverse event.
Observation:
- A 51-year-old male developed anti-GAD antibody positive autoimmune encephalitis.
- Symptoms included cognitive impairment and behavioral changes.
- Onset occurred shortly after the second mRNA COVID-19 vaccine dose.
Findings:
- The patient showed positive response to high-dose steroid and IV immunoglobulin therapy.
- This case suggests autoimmune encephalitis, specifically anti-GAD positive, as a possible vaccine side effect.
- Early diagnosis and prompt treatment are crucial for favorable outcomes.
Implications:
- Highlights a potential, albeit rare, neurological adverse event following COVID-19 vaccination.
- Emphasizes the importance of considering autoimmune encephalitis in post-vaccination neurological presentations.
- Further large-scale observational studies are needed to establish causality and understand the incidence of vaccine-related autoimmune encephalitis.
Abstract:
Since December 2020, a significantly higher number of people worldwide have been vaccinated for coronavirus disease 2019 (COVID-19). Neurological complications have been reported after these vaccines, although a definitive causal relationship has not been proven in the available literature. We describe a 51-year-old man presenting with anti-glutamic acid decarboxylase (anti-GAD) antibody positive autoimmune encephalitis with progressive cognitive impairment and behavioral abnormalities, presenting shortly after the second dose of mRNA COVID-19 vaccine, possibly representing a serious vaccine-related adverse event. Response to high-dose steroid and intravenous immunoglobulin treatment was positive. As many people around the world have been vaccinated against COVID-19, this case shows that autoimmune encephalitis and even anti-GAD antibody positive autoimmune encephalitis can develop as a side effect after this new vaccine, but with early diagnosis and appropriate treatment, the clinic can have a good prognosis. Observational studies with large numbers of patients are needed to explain causality.
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