Human vaccines & immunotherapeutics | 2021
Laryngeal myasthenia gravis following influenza vaccination: a case report and literature review.
Abstract
BACKGROUND\nMyasthenia gravis (MG) is an autoimmune disease of acquired neuromuscular junction transmission disorder mediated by auto-antibodies. Extranophthalmic muscles are the most susceptible to MG, while the larynx muscle may also be affected. MG can be aggravated by various types of drugs. In the present study, a patient with laryngeal MG who received an influenza vaccination 5\xa0days before onset was treated, which has not been previously reported.\n\n\nCASE PRESENTATION\nA 58-year-old Asian woman developed mild dysphagia and severe dysarthria five days after receiving a trivalent inactivated influenza vaccine. The patient s quantitative MG score was 4 (1 for swallowing and 3 for speech), and the patient s neurological symptoms varied. The serum acetylcholine receptor (AChR) antibody titer was 0.67\xa0nmol/L (normal range below 0.2\xa0nmol/L), and other immunological and thyroid function tests were negative. As revealed by chest computed tomography (CT), there was no thymus abnormality. Based on the patient s history, clinical features, and examination results, the patient was diagnosed with laryngeal MG. The patient received pyridostigmine oral administration (60 mg/d) and steroid therapy (Prednisone, oral, 60 mg/d). The patient s symptoms began to improve after 7\xa0days of treatment, and were significantly relieved after 2\xa0weeks.\n\n\nCONCLUSION\nInfluenza vaccination might cause an unexpected abnormal autoimmune response in MG as a very rare event. Further research is needed to assess the possible causal relationship between the influenza vaccine and neurological complications, also in addition to the safety of the vaccine.