Potential autoimmune encephalitis following yellow fever vaccination: A report of three cases

Guedes, Bruno Fukelmann; Ribeiro, Ana Freitas; Pinto, Lécio Figueira; Vidal, José Ernesto; Oliveira, Fernanda Gurgel de; Sztajnbok, Jaques; Oliveira, Augusto César Penalva de; Simabukuro, Mateus Mistieri

doi:10.1016/j.jneuroim.2021.577548

Cited by 16 publications

(16 citation statements)

References 18 publications

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“…Recently, single reports described immune-mediated encephalitis as a rare complication of SARS-CoV-2 vaccination ( Kaulen et al, 2022 , Zuhorn et al, 2021 ). In agreement, previous studies have shown that other vaccinations, particularly that of Japanese yellow fever, have been associated with antibody-mediated disorders, such as anti-N-Methyl-D-Aspartate receptor (NMDAR) encephalitis ( Guedes et al, 2021 ).…”

supporting

confidence: 86%

Safety profile of SARS-CoV-2 vaccination in patients with antibody-mediated CNS disorders

Dinoto

Gastaldi

Iorio

et al. 2022

Multiple Sclerosis and Related Disorders

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supporting

confidence: 86%

Safety profile of SARS-CoV-2 vaccination in patients with antibody-mediated CNS disorders

Dinoto

Gastaldi

Iorio

et al. 2022

Multiple Sclerosis and Related Disorders

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“…N-methyl-D-aspartate receptor (NMDA-r) IgG was identified in serum and CSF of the second and third patients. These 3 cases are described in greater detail elsewhere ( 14 ). All 3 cases met the BC encephalitis case definition and the CDC criteria for level 2 neurotropic disease.…”

Section: Resultsmentioning

confidence: 99%

Neurologic Disease after Yellow Fever Vaccination, São Paulo, Brazil, 2017–2018

Ribeiro¹,

Guedes²,

Sulleiman³

et al. 2021

Emerg. Infect. Dis.

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In support of improving patient care, this activity has been planned and implemented by Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.Medscape, LLC designates this Journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test with a 75% minimum passing score and complete the evaluation at http://www.medscape.org/journal/eid; and (4) view/print certificate. For CME questions, see page XXX.

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“…Extensive workup showed no evidence that patient's symptoms were due to a paraneoplastic condition, which is more common for this specific neurologic condition. Instead, based on precedent cases of anti-NMDAR encephalitis caused by vaccines against influenza, yellow fever, Japanese encephalitis, and tetanus/diphtheria vaccines, clinicians in this case quickly considered the recent receipt of SARS-CoV-2 vaccine as a possible trigger of anti-NMDAR encephalitis (3,(12)(13)(14).…”

Section: Discussionmentioning

confidence: 99%

“…Anti-NMDAR encephalitis has been associated with viral illnesses such as Japanese encephalitis, HSV-1, Epstein-Barr virus, and most recently COVID-19 infection (Table 1) (5,(9)(10)(11). Additionally, anti-NMDAR encephalitis has been associated with vaccinations against H1N1, yellow fever, TdaP-IPV booster, and the Japanese Encephalitis (3,(12)(13)(14). In this case report, we present the first instance of anti-NMDAR encephalitis after receiving the Pfizer-BioNTech COVID-19 vaccine.…”

Section: Introductionmentioning

confidence: 99%

Acute Psychosis Due to Anti-N-Methyl D-Aspartate Receptor Encephalitis Following COVID-19 Vaccination: A Case Report

et al. 2021

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Anti-N-methyl D-aspartate (NMDA) receptor (anti-NMDAR) encephalitis has been reported after SARS-CoV-2 infection, but not after SARS-CoV-2 vaccination. We report the first known case of anti-NMDAR encephalitis after SARS-CoV-2 immunization in a young female presenting with acute psychosis, highlighting a rare potential immunological complication of vaccination against SARS-CoV-2 that is currently being distributed worldwide. The patient presented initially with anxiety and hypochondriacal delusions which progressed to psychosis and catatonia but returned to baseline with aggressive immunomodulatory therapy consisting of intravenous immunoglobulin, high-dose glucocorticoids, and rituximab. This study highlights that the workup of acute psychosis should include establishing a history of recent vaccination followed by a thorough neurological assessment, including for anti-NMDAR antibodies in blood and cerebrospinal fluid.

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Potential autoimmune encephalitis following yellow fever vaccination: A report of three cases

Cited by 16 publications

References 18 publications

Safety profile of SARS-CoV-2 vaccination in patients with antibody-mediated CNS disorders

Safety profile of SARS-CoV-2 vaccination in patients with antibody-mediated CNS disorders

Neurologic Disease after Yellow Fever Vaccination, São Paulo, Brazil, 2017–2018

Acute Psychosis Due to Anti-N-Methyl D-Aspartate Receptor Encephalitis Following COVID-19 Vaccination: A Case Report

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