Post-vaccination MDEM associated with MOG antibody in a subclinical Chlamydia infected boy
| Autor: | Shuichi Shimakawa, Hideto Nakajima, Douglas Kazutoshi Sato, Yasushi Shigeri, Ichiro Nakashima, Hiroshi Tamai, Kohji Azumagawa, Takuya Tanabe, Shohei Nomura, Leslie Sargent Jones, Mitsuru Kashiwagi |
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| Rok vydání: | 2016 |
| Předmět: |
Male
0301 basic medicine medicine.disease_cause Rubella Antibodies 03 medical and health sciences 0302 clinical medicine Developmental Neuroscience Antigen Demyelinating disease medicine Humans Child Subclinical infection Chlamydia business.industry Encephalomyelitis Acute Disseminated Vaccination Brain General Medicine Chlamydia Infections Chlamydophila pneumoniae medicine.disease Magnetic Resonance Imaging Virology 030104 developmental biology Immunization Pediatrics Perinatology and Child Health Acute disseminated encephalomyelitis Immunology Myelin-Oligodendrocyte Glycoprotein Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Brain and Development. 38:690-693 |
| ISSN: | 0387-7604 |
| DOI: | 10.1016/j.braindev.2016.02.004 |
| Popis: | The mechanism of post-vaccination acute disseminated encephalomyelitis (ADEM) has been hypothesized as resulting from vaccination-injected antigens cross-reacting with myelin components, however, a precise etiology has been uncertain. In this report, we describe the case of a 6-year-old Japanese boy who had multiphasic disseminated encephalomyelitis (MDEM), and was positive for both anti-myelin oligodendrocyte glycoprotein (MOG) antibodies and Chlamydophila pneumoniae antibodies. After vaccinations that were the second one for measles and rubella, and the booster immunization for Japanese encephalitis, the patient presented with fever, headache, vomiting, and a change in personality. He was treated with a high-dose of intravenous methylprednisolone in the diagnosis of ADEM. However, these symptoms recurred with different magnetic resonance imaging lesion, and he was diagnosed as MDEM. Retrospective testing for pathogens revealed C. pneumoniae IgM and IgG antibodies, and it was considered that he was infected with C. pneumoniae subclinically. The patient's serum indicated a positive response for the anti-MOG antibody from the onset of the ADEM diagnosis and in all recurrent episodes. Chlamydia species infection has been known to play a role in demyelinating diseases. It is also known that the anti-MOG antibody may be present but not exhibit its pathogenesis in the absence of a cell-mediated inflammatory response; however, the precise mechanism of action of the anti-MOG antibodies is not yet determined. We propose the possibility that post-vaccination demyelinating disease may result from the synergistic effects of a preceding anti-MOG antibody, possibly produced in response to a subclinical Chlamydia species infection. |
| Databáze: | OpenAIRE |
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