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A case of rapidly progressive amyotrophic lateral
sclerosis associated with SOD1 mutation (p.D126H
variant) following COVID-19 vaccination
1Chen Fei Ng, 2Nortina Shahrizaila, 3Azlina Ahmad-Annuar, 4Suzanna Edgar, 5Hui
Jan Tan, 5Rabani Remli
1Department of Neurology, Sunway Medical Centre, Bandar Sunway, Subang Jaya, Selangor, Malaysia;
2Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala
Lumpur, Malaysia; 3Department of Biomedical Science, Faculty of Medicine, University of Malaya,
Kuala Lumpur, Malaysia; 4Department of Medicine, Faculty of Medicine, University of Malaya, 50604
Kuala Lumpur, Malaysia; 5Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia
Medical Centre, Kuala Lumpur, Malaysia.
Abstract
Mutations in common amyotrophic lateral sclerosis (ALS) genes have been reported in sporadic ALS.
In the current case, we describe a patient without known family history who was found to harbour a
SOD1 mutation (p.D126H variant) and who developed ALS following COVID-19 vaccination. This
mutation has only been previously reported once three decades ago in a British family. Although
COVID-19 vaccination in itself is unlikely to contribute to the development of ALS, the possibility
that vaccination could play a part in triggering the onset of disease in patients with risk variants
merits further study.

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