Recurrent acute-onset of chronic inflammatory demyelinating polyneuropathy after COVID-19 vaccination

Abstract

This is the case of 54-year-old male with a past medical history of Chronic Inflammatory Demyelinating Polyneuropathy (CIPD) who was found to have an acute exacerbation of CIPD shortly after receiving his 1st COVID 19 booster (3rd dose of vaccination series) and was successfully treated with intravenous immunoglobulin (IVIG) and then was found to have another acute exacerbation of CIDP 6 months later after receiving his 2nd COVID 19 booster (4th dose of vaccination series) that required intubation and long term tracheostomy. CIPD is an acquired immune-mediated polyneuropathy that mainly affects the peripheral nerve roots nerves. It typically presents with relapsing/remitting, or progressive symmetrical muscle weakness and sensory involvement and can cause decreased respiratory effort. COVID-19 is mainly a respiratory disease, but it has been associated with a wide variety of neurological conditions. Although there have been several findings of acute inflammatory demyelinating polyneuropathy in association with COVID-19, CIDP exacerbation as a result of COVID-19 has rarely been seen in the literature. Furthermore, CIDP exacerbation as a result of COVID-19 vaccination is even less frequently seen.