mRNA COVID-19 Aþýsý ile Ýliþkili Yeni Baþlangýçlý Sistemik Myastenik Kriz: Ýlk Pediatrik Olgu

Myastenia gravis (MG), anormal nöromüsküler iletim ile karakterize otoimmün bir hastalýktýr. Timusun MG patogenezinde anahtar rol oynadýðýna inanýlmaktadýr ve timektomi hastalýk için önemli bir tedavi seçeneðidir. Koronavirüs hastalýðý 2019 (COVID-19) aþýlarýný takiben alevlenmeler ve yeni baþlangýçlý MG vakalarý literatürde daha önce bildirildiði gibi, Guillain Barre Sendromu gibi otoimmüniteyle yüksek iliþkisi bulunan birçok komplikasyon aþýlama sonrasý bildirilmiþtir.
Bu çalýþmada, yakýn zamanda COVID-19 aþýsý yapýldýktan sonra ilk ataðý ortaya çýkan, video yardýmlý torakoskopik (VATS) timektomiden kýsa süre sonra semptomlarda gerileme yaþayan daha önce saðlýklý bir pediatrik MG hastasýný sunduk. Güncel literatür ýþýðýnda BNT162b2 aþýlamasýyla iliþkili jeneralize güçsüzlük ve ciddi solunum sýkýntýsýyla prezente olan ve izlemde MG ve timoma tanýsý alan ilk pediatrik hastayý sunarak literatüre bu oldukça nadir durum hakkýnda katkýda bulunmayý amaçladýk.

First Paediatric Case of mRNA COVID-19 Vaccine Associated New Onset Systemic Myasthenic Crisis

Myastenia gravis (MG) is an autoimmune disorder characterized by abnormal neuromuscular conduction. The thymus is believed to play a key role in the pathogenesis of MG so that thymectomy is an important treatment option for the disease. As MG exacerbations and new-onset MG cases following Coronavirus disease 2019 (COVID-19) vaccinations have been previously reported in the literature, a variety of complications that are highly related to autoimmunity, such as Guillain Barre Syndrome, have been reported after vaccination. A previously healthy girl developed her first life-threatening systemic myasthenia gravis (MG) attack following administration of the messenger RNA (mRNA) BNT162b2 COVID-19 vaccine. Despite receiving treatment targeting MG, her clinical status did not show significant improvement, which led to the decision to perform a thymectomy via the video-assisted thoracoscopic surgery (VATS) approach. After the procedure, a significant improvement was observed in her clinical condition. We aimed to contribute to the literature about this rarely encountered condition by reporting the first paediatric case in our country presenting with BNT162b2 vaccination-associated generalized weakness and severe respiratory distress, who was diagnosed with MG and thymoma during follow-up, in the light of the contemporary literature. This situation also serves as a warning for other mRNA vaccines.