Immune triggers preceding neuralgic amyotrophy.

Autor: Sparasci D; Department of Neurology, Neurocenter of Southern Switzerland EOC, Lugano, Switzerland., Schilg-Hafer L; Department of Neurology, Cantonal Hospital, St Gallen, Switzerland., Schreiner B; Department of Neurology, University and Hospital Zurich, Zurich, Switzerland., Scheidegger O; Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland., Peyer AK; Department of Neurology, University Hospital and University of Basel, Basel, Switzerland., Lascano AM; Neurology Division, Department of Clinical Neuroscience, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland., Vicino A; Nerve-Muscle Unit, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland., Décard BF; Cantonal Hospital, Lucerne, Switzerland., Tsouni P; Department of Neurology, Hôpital du Valais, Sion, Switzerland., Humm AM; Neurology Unit, Department of Medicine, HFR Fribourg Cantonal Hospital, Fribourg, Switzerland., Pianezzi E; Laboratory of Microbiology EOC, Bellinzona, Switzerland., Zezza G; Laboratory of Microbiology EOC, Bellinzona, Switzerland., Hundsberger T; Department of Neurology, Cantonal Hospital, St Gallen, Switzerland., Dietmann A; Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland., Jung HH; Department of Neurology, University and Hospital Zurich, Zurich, Switzerland., Kuntzer T; Nerve-Muscle Unit, Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland., Wilder-Smith E; Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.; Cantonal Hospital, Lucerne, Switzerland., Martinetti-Lucchini G; Laboratory of Microbiology EOC, Bellinzona, Switzerland., Petrini O; University of Applied Sciences and Arts of Southern Switzerland, Bellinzona, Switzerland., Fontana S; Blood Transfusion Service SRC Southern Switzerland, Lugano, Switzerland.; Interregional Blood Transfusion SRC, Bern, Switzerland., Gowland P; Interregional Blood Transfusion SRC, Bern, Switzerland., Niederhauser C; Interregional Blood Transfusion SRC, Bern, Switzerland.; Institute for Infectious Diseases, University of Bern, Bern, Switzerland., Gobbi C; Department of Neurology, Neurocenter of Southern Switzerland EOC, Lugano, Switzerland.; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland., Ripellino P; Department of Neurology, Neurocenter of Southern Switzerland EOC, Lugano, Switzerland.; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.
Jazyk: angličtina
Zdroj: European journal of neurology [Eur J Neurol] 2024 Dec; Vol. 31 (12), pp. e16462. Date of Electronic Publication: 2024 Oct 04.
DOI: 10.1111/ene.16462
Abstrakt: Background and Purpose: Infections and vaccinations have been identified as potential immunological triggers of neuralgic amyotrophy (NA), but the exact type and frequency of the preceding agents is unknown.
Methods: This was a multicentre, prospective, observational, matched case-control study. NA was diagnosed by neuromuscular experts according to validated clinical criteria and electrodiagnostic studies. Clinical data and biological samples of NA patients were collected within 90 days from disease onset between June 2018 and December 2023. All NA patients were asked about prior infection and vaccination in the month before disease onset. Serological tests for hepatitis E virus, human immunodeficiency virus, severe acute respiratory syndrome coronavirus 2, Epstein-Barr virus, cytomegalovirus, parvovirus B19, varicella-zoster virus, Borrelia burgdorferi, Mycoplasma pneumoniae and Bartonella henselae were performed in a central laboratory. Each case was matched with a healthy control for age, sex, place of residence and time of blood collection.
Results: Fifty-seven patients and corresponding controls were included. The mean age was 45 years for both groups. NA onset was preceded by a symptomatic infectious trigger confirmed by microbiological tests in 15/57 (26.3%) patients. Coronavirus disease 2019 vaccination was considered a potential trigger in 7/57 (12.3%) subjects. An acute viral infection was associated with a bilateral involvement of the brachial plexus (p = 0.003, Cramèr's V = 0.43).
Conclusions: Confirmed immune triggers (infection or vaccination) preceded disease onset in 22/57 (38.6%) NA cases. We suggest to test NA patients in the acute phase for intracellular antigens, especially in the case of concomitant bilateral involvement and hepatitis.
(© 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)
Databáze: MEDLINE
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