Sex: M
Vaccine: COVID19
Symptoms: Albumin globulin ratio, Alpha 1 globulin, Alpha 2 globulin, Angiotensin converting enzyme, Beta 2 globulin
Clinical narrative: GUILLAIN-BARRE SYNDROME; This spontaneous report received from a patient concerned a male of an unspecified age. The patient's height, and weight were not reported. The patient's past medical history included: sarcoidosis, and spondylolisthesis (10 years ago between lumbar 5 to S1). On 10-AUG-2009, Magnetic resonance imaging (MRI) of lumbar spine was performed which had shown spondylolisthesis. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A expiry: 21-SEP-2021) dose was not reported,1 total, administered on 17-SEP-2021 16:03 for covid-19 prophylaxis. On the same day, within 2 hours post vaccination, patient had lost all sensation in body especially penis and described as when patient went to pee he could not feel himself touching and later he had visited the nerve specialist. On 18-SEP-2021, next day, all his sensation had gone and it had run through fingers, over hair, arms, legs. He could not feel his sensation and he had not lost all sensation in his fingertips and toes it was just diminished but he can feel pressure and recovered from tingling sensation. Over a couple of days, he observed that there was a missing sensation in other places too but not entire body, only arms and legs.  On 20-SEP-2021, the patient had tested negative for COVID-19 (coronavirus disease-19 polymerase chain reaction). On 22-OCT-2021, Laboratory tests were performed using blood sample, Angiotensin converting enzyme (ACE test) based on sarcoid and sample was sent to clinic and took a week to get back the results and that came back with a value of 65 U/L (NR: 14 - 82). Rapid plasma reagin (RPR) test was performed for confirmatory syphilis antibody and RPR titer diagnostic which had shown results as non-reactive. On the same day, urine protein electrophoresis (PEP) test was performed which had shown results as no monoclonal bands noted and this pattern shows predominantly albumin to rule out hence jones protein, urine immunofixation electrophoreisis would be required if clinically indicated and Protein urine random value (NR: not provided) was 14.7 mg/dL (high). On 26-OCT-2021, Laboratory data included: A/G (albumin/globulin ratio) ratio 1.52, Albumin (NR: 3.5 - 4.7) 4.1 g/dL, Alpha 1 globulin (NR: 0.2 - 0.5) 0.3 g/dL, Alpha 2 globulin (NR: 0.5 - 1.0) 0.7 g/dL, Beta 2 globulin (NR: 0.2 - 0.5) 0.3 g/dL, Beta 1 globulin (NR: 0.4 - 0.6) 0.4 g/dL, and Gamma globulin (NR: 0.6 - 1.5) 1.0 g/dL. On an unspecified date, 2 months post vaccination, patient had visited another physician where they told motor nerves were functioning properly but sensory nerves incapacitated and later follow up with physician, patient was 10 percent better but he seemed to think they would come back little bit on his skin and arms and at that point he was extremely frustrated since he had zero sensation in his penis.  On 19-NOV-2021, MRI (MRIs of lumbar spine without contrast) was performed to check for a pinched nerve to make sure it was not something else and then results showed as narrative and impression comparison was done with MRI Lumbar Spine without contrast performed and indications DDD (degenerative disk disease lumbar) findings, paraspinal area was normal with no visible mass, bones chronic bilateral spondeylolysis at L5 with anterior listhesis that measure approximately 1 cm. On the same day MRI of cervical spine without contrast was performed for which results were not reported. On 05-JAN-2022, the patient had again visited the specialist.  On 19-JAN-2022, the patient had tested positive for COVID-19 for which patient had to wait for an week to get an next appointment with the physician, later after the physician visit, the results were similar to that previous results. On 25-JAN-2022, the patient had tested negative for COVID-19. He had lab work done around this time.  On 01-MAR-2022, more blood tests were performed for which results were not reported. Later 6 to 9 months, post vaccination, some of the missing sensations came back and felt like something pokes him like a needle down lower and sometimes he feels it and sometimes patient could not feel it, when he gets scratched, patient did not feel it at all at penis. Later within 3 days patient again was called to see a specialist. On 05-APR-2022, they had performed nerve conduction study on arms, finger tips, legs but not penis and results are motor nerves were fully functional but his sensory nerves were damaged and were operating at 10-15 percent. The physician had diagnosed it to be the Guillain-barre syndrome (GBS). On 06-JUL-2022, again he had visited the physician and they had performed nerve conduction studies which had shown results as some sensory nerves were better, 5-10 percent better and had shown some improvement. He had later seen his own physician and other physicians as well. On OCT-2022, Laboratory data included: Protein total (NR: 6.4 - 8.2) 6.9 g/dL. On an unspecified date, Laboratory data included: X-ray of cervical spine (Spine cervical 5 view x-ray) and X-ray of lumbar spine (spine lumbar complete 4 plus view) was performed for which results were Not reported, and X-ray of thoracic spine (X-Ray thoracic 2 view) was performed and shown no acute fracture or deformity, thoracic spine is in normal anatomic alignment, vertebral body heights are maintained, disk faces are preserved and no soft tissue abnormality. The patient felt like was neutered and it was very difficult for him to maintain erection. He feels like cheese was sliding off his crackers and he informed physician that this feeling would be because he had some tingling down his legs before. He visited neurosurgeon/ spine surgeon where they told that this is from riding moto, hit bump and touched nerve which caused him tingling. After few days he had again visited the same physician and physician informed as nothing has changed in last 10 years.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from guillain-barre syndrome. This report was serious (Other Medically Important Condition). This report was associated with a product quality complaint: 90000272766. This case, from the same reporter is linked to 20230258589.; Sender's Comments: V0: 20230258457-Guillain-Barre syndrome. The event has a compatible/suggestive temporal relationship, and is labeled. There is no information on any other factors potentially associated with the event. Therefore, this event is considered consistent with vaccine administration.