Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2022; 10(34): 12617-12622
Published online Dec 6, 2022. doi: 10.12998/wjcc.v10.i34.12617
Amyloid β-related angiitis of the central nervous system occurring after COVID-19 vaccination: A case report
Mayuki Kizawa, Yasushi Iwasaki
Mayuki Kizawa, Department of Pathology, Tokai Central Hospital, Kakamigahara 504-8601, Japan
Yasushi Iwasaki, Bulletin of The Institute for Medical Science of Aging, Aichi Medical University, Nagakute City 480-1195, Japan
Author contributions: Kizawa M made a pathological diagnosis, reviewed the literature, and contributed to the manuscript; Iwasaki Y provided diagnostic support and assisted in writing the paper; Both authors have read and approved the final manuscript.
Informed consent statement: Informed consent was obtained from the patient for the publication of this report and any associated images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mayuki Kizawa, MD, PhD, Doctor, Department of Pathology, Tokai Central Hospital, 4-6-2 Soharahigashijima-cho, Kakamigahara 504-8601, Japan. kizawa.m@tokaihp.jp
Received: May 22, 2022
Peer-review started: May 22, 2022
First decision: August 21, 2022
Revised: October 1, 2022
Accepted: November 8, 2022
Article in press: November 8, 2022
Published online: December 6, 2022
Processing time: 186 Days and 1 Hours
Abstract
BACKGROUND

Although coronavirus disease 2019 (COVID-19) vaccines have been effective in controlling the COVID-19 pandemic, a variety of post-vaccination neurological complications have been reported worldwide. Amyloid β-related angiitis (ABRA) is a rare neurological disease. The underlying cause of ABRA is unknown, but several studies suggest that it is caused by an excessive immune response to amyloid-β deposited in blood vessels. In addition, limited attention has been paid to potential triggers of ABRA, such as infection or vaccination.

CASE SUMMARY

We report a case of ABRA that developed 2 wk after COVID-19 vaccination. A 75-year-old woman developed a frontal headache after receiving a second dose of COVID-19 BNT162b2 vaccine (Pfizer-BioNTech). Diffusion-weighted magnetic resonance imaging (DW-MRI) of the head showed abnormal hyperintensity, suggesting cerebral infarctions in the left parietal and occipital lobes. We diagnosed her condition as ABRA based on a brain biopsy. We administered steroid pulse therapy and the patient’s symptoms and DW-MRI abnormalities improved. This case had a good outcome due to prompt diagnosis and treatment.

CONCLUSION

We report a case of ABRA that may have been triggered by COVID-19 vaccination.

Keywords: Amyloid β-related angiitis; COVID-19; Neurological complications; Vaccination; Case report

Core Tip: Amyloid β-related angiitis (ABRA) is a rare neurological disease with overlapping features of cerebral amyloid angiopathy and primary angiitis of the central nervous system. We present a case of ABRA that appeared 2 wk after coronavirus disease 2019 (COVID-19) vaccination. The patient was diagnosed with ABRA based on a brain biopsy. Steroid pulse therapy was administered, and, the patient’s symptoms and diffusion-weighted magnetic resonance imaging abnormalities improved. This case had a good outcome due to prompt diagnosis and treatment. Although the relationship between ABRA and COVID-19 vaccination is unclear, this case contributes to the literature on adverse neurological events following COVID-19 vaccination.