新型コロナワクチン（BNT162b2）接種後にギラン・バレー症候群を生じた71歳女性例

A Patient Developing Guillain-Barré Syndrome After Receiving the BNT162b2 COVID-19 mRNA Vaccine

71歳，女性。新型コロナワクチン接種の1週間後から両大腿内側のビリビリ感と下痢，2週間後に排尿障害と歩行障害が出現し，4週間後に歩行障害はピークとなり，無治療で改善傾向となった。急性単相性の経過や脳脊髄液蛋白細胞解離の顕在化などからギラン・バレー症候群と診断した。先行感染は確認されずワクチンに関連したものと考えた。筋力低下が下肢近位筋や体幹筋優位であり，典型的なギラン・バレー症候群とは異なっていた。

Abstract

We report a 71-year-old woman who presented with paresthesia, progressive weakness, difficulty walking, diarrhea, and bladder dysfunction one week after she received the BNT162b2 COVID-19 vaccine. Her neurological signs and symptoms gradually worsened up to 27 days after onset, after which her weakness slowly improved without immunotherapy. Analysis of serial cerebrospinal fluid specimens showed gradually increasing protein levels. Results of a nerve conduction study suggested functional axonal disturbance. The clinical findings together with the monophasic clinical course were consistent with Guillain-Barré syndrome. Her previous history was negative for symptomatic infection. Serological and bacterial tests, including the presence of anti-glycolipid antibodies, were negative for prior infection. Few cases have been reported on the development of Guillain-Barré syndrome after the BNT162b2 vaccine. Our patient's syndrome was characterized by atypical proximal weakness of the dominant lower limb.

(Received January 28, 2022; Accepted April 4, 2022; Published August 1, 2022)