Acute disseminated encephalomyelitis following inactivated influenza vaccination in the Brazilian Amazon: a case report

Andrade, Solange Dourado de; Andrade, Maria Graciede Filha Santarém; Santos, P. J. T.; Galvão, Maria de Lourdes de Souza; Barros, Mariana Martins de; Ramasawmy, Rajendranath; Safe, Izabella Picinin; Monteiro, Wuelton Marcelo; Sabidó, Meritxell; Alecrim, Maria das Graças Costa

doi:10.1590/0037-8682-0314-2014

Cited by 4 publications

(3 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A total of 36 articles were excluded on the basis of reports not identifiable with abstract ( n =19), full text not in the English language ( n =5), and unavailability of full text ( n =12). The remaining 19 case reports 4 – 6 , 9 – 24 were deemed eligible for inclusion in this study (Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…This review included 23 cases from all 19 included articles 4 – 6 , 9 – 24 , summarized in Table 1 . Case reports originated from 10 different countries, with Japan accounting for most of the cases (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Even though vaccinations are often secure and well-tolerated, uncommon adverse events following immunization sometimes happen. A temporal relationship between ADEM and the administration of influenza vaccinations has been proposed by several case reports 4 – 6 . These findings have stirred discussions and prompted inquiries into whether there could be a causal connection.…”

Section: Introductionmentioning

confidence: 98%

See 2 more Smart Citations

Neurological complications of influenza vaccination: navigating the spectrum with a focus on acute disseminated encephalomyelitis (ADEM)

Mashkoor,

Nadeem,

Fatima

et al. 2024

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

Introduction: Acute Disseminated Encephalomyelitis (ADEM) is a rare neurological disorder characterized by inflammation in the brain and spinal cord. This systematic review aims to investigate the potential association between ADEM and influenza vaccination by analyzing relevant case reports. ADEM is traditionally thought to be a monophasic condition, predominantly affecting children, often following viral illnesses or immunizations. Recent attention has focused on a possible link between ADEM and influenza vaccination, prompting the need for a thorough investigation. Methods: The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the AMSTAR2 guidelines. Electronic searches were conducted on PubMed, Cochrane Library, and clinicaltrials.gov databases, spanning up to August 2023. Inclusion criteria encompassed full-text articles in English, observational studies, case reports, and case series providing comprehensive details for confirming clinical diagnoses of ADEM following influenza vaccination. Data were extracted, including demographic information, vaccination details, clinical symptoms, diagnostic evaluations, treatment modalities, and outcomes. Quality assessment was performed using the Joanna Briggs Institute (JBI) Critical Appraisal tool. Results: A total of 23 cases of ADEM following influenza vaccination were identified from 19 included articles. The mean age of affected individuals was 40.2 years (±25.7) with 60.8% being male. Common presenting symptoms included muscle weakness (52.1%), urinary abnormalities (30.4%), altered consciousness (26%), and sensory disturbances (26%). Neurological examination revealed findings such as extensor plantar reflex (positive Babinski sign) in 26%, hyperreflexia in 30.4%, and generalized hyporeflexia in 13% of the cases. Diagnostic evaluations involved MRI, showing multiple hyperintense lesions in cerebral hemispheres (43.4%), subcortex (60.8%), and spinal cord (39.1%). Cerebrospinal fluid analysis indicated elevated white blood cell count in 69.5% of cases, with lymphocytic pleocytosis in 52.1%. Oligoclonal bands were reported positively in 8.6% of cases. Treatment approaches varied, with intravenous methylprednisolone being the most common (39.1%). Out of the 23 cases, two (8.6%) patients had a fatal outcome, while the rest showed clinical improvement with complete or partial resolution of symptoms. Persisting symptoms included numbness in the lower extremities (8.6%) and impaired ability to walk after 10 months (4.3%). Conclusion: While the association between ADEM and influenza vaccination is rare, healthcare professionals should remain vigilant and consider patients’ vaccination history, particularly following an influenza immunization. This systematic review highlights the clinical manifestations, diagnostic tools, treatment approaches, and outcomes of ADEM cases post-influenza vaccination. Further research is essential to understand this association and improve clinical decision-making, ensuring the safety and efficacy of immunization programs.

show abstract