Small Fiber Neuropathy Following Vaccination

Kafaie, Jafar; Kim, Min‐Soo; Krause, Erik

doi:10.1097/cnd.0000000000000130

Cited by 29 publications

(23 citation statements)

References 16 publications

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“…Single studies have previously described SFN and END reduction in young patients with pain symptoms. Only a few children with pain showed a severely reduced END consistent with the findings in our study . In our cohort, the degree of END did not correlate with pain distribution or pain progression.…”

Section: Discussionsupporting

confidence: 91%

Diagnostic utility of small fiber analysis in skin biopsies from children with chronic pain

et al. 2019

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Introduction: Small fiber neuropathies (SFN) are associated with a reduction in quality of life. In adults, epidermal nerve fiber density (END) analysis is recommended for the diagnosis of SFN. In children, END assessment is not often performed. We analyzed small nerve fiber innervation to elucidate the potential diagnostic role of skin biopsies in young patients with pain.Methods: Epidermal nerve fiber density and sudomotor neurite density (SND) were assessed in skin biopsies from 26 patients aged 7 to 20 years (15 female patients) with unexplained chronic pain. The results were compared with clinical data.Results: Epidermal nerve fiber density was abnormal in 50% and borderline in 35% of patients. An underlying medical condition was found in 42% of patients, including metabolic, autoimmune, and genetic disorders.Discussion: Reduction of epidermal nerve fibers can be associated with treatable conditions. Therefore, the analysis of END in children with pain may help to uncover a possible cause and guide potential treatment options. K E Y W O R D Sepidermal nerve fiber density, neuropathic pain, skin biopsy, small fiber, small fiber neuropathy, sudomotor neurite density, sweat gland innervation Abbreviations: AOI, area of interest; END, epidermal nerve density; NCS, nerve conduction study; PBS, phosphate-buffered saline; PGP 9.5, protein gene product 9.5; QST, quantitative sensory testing; SFN, small fiber neuropathy; SG, sweat glands; SND, sudomotor neurite density; TRP, transient receptor potential.

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Section: Discussionsupporting

confidence: 91%

Diagnostic utility of small fiber analysis in skin biopsies from children with chronic pain

et al. 2019

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“…107 It was followed by dozens of similar case reports of POTS following HPV vaccination, all within 2 months of receiving the vaccine. [108][109][110][111][112][113][114] Among these were two case series, compiling a total of 88 women, all presenting no more than 2 months following vaccination, complaining of orthostatic intolerance, with additional complaints such as nausea, palpitations, fatigue and neuropathic pain. Out of the two series, a total of 49 (55%) fulfilled the diagnostic criteria for POTS.…”

Section: Systemic Lupus Erythematosusmentioning

confidence: 99%

Vaccine-induced autoimmunity: the role of molecular mimicry and immune crossreaction

2018

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Since the early 1800s vaccines have saved numerous lives by preventing lethal infections. However, during the past two decades, there has been growing awareness of possible adverse events associated with vaccinations, cultivating heated debates and leading to significant fluctuations in vaccination rates. It is therefore pertinent for the scientific community to seriously address public concern of adverse effects of vaccines to regain public trust in these important medical interventions. Such adverse reactions to vaccines may be viewed as a result of the interaction between susceptibility of the vaccinated subject and various vaccine components. Among the implicated mechanisms for these reactions is molecular mimicry. Molecular mimicry refers to a significant similarity between certain pathogenic elements contained in the vaccine and specific human proteins. This similarity may lead to immune crossreactivity, wherein the reaction of the immune system towards the pathogenic antigens may harm the similar human proteins, essentially causing autoimmune disease. In this review, we address the concept of molecular mimicry and its application in explaining post vaccination autoimmune phenomena. We further review the principal examples of the influenza, hepatitis B, and human papilloma virus vaccines, all suspected to induce autoimmunity via molecular mimicry. Finally, we refer to possible implications on the potential future development of better, safer vaccines.

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“…Children can also suffer from SFN. Although SFN in children is difficult to diagnose because of the absence of normative data for intraepidermal nerve fiber density (IENFD) in children, several case reports have been published …”

Section: Epidemiologymentioning

confidence: 99%

“…Although SFN in children is difficult to diagnose because of the absence of normative data for intraepidermal nerve fiber density (IENFD) in children, several case reports have been published. [16][17][18][19] 2.1 | Quality of life SFN leads to a significant reduction in the overall QoL, 20 at least in part due to pain and autonomic symptoms. Thermal thresholds and reduced IENFD have been reported to correlate with the deterioration of QoL.…”

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confidence: 99%

Small‐fiber neuropathy: Expanding the clinical pain universe

Sopacua

Hoeijmakers

Merkies

et al. 2019

J Peripheral Nervous Sys

105

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Small‐fiber neuropathy (SFN) is a disorder of thinly myelinated Aδ and unmyelinated C fibers. SFN is clinically dominated by neuropathic pain and autonomic complaints, leading to a significant reduction in quality of life. According to international criteria, the diagnosis is established by the assessment of intraepidermal nerve fiber density and/or quantitative sensory testing. SFN is mainly associated with autoimmune diseases, sodium channel gene variants, diabetes mellitus, and vitamin B12 deficiencies, although in more than one half of patients no etiology can be identified. Recently, gain‐of‐function variants in the genes encoding for the Nav1.7, Nav1.8 and Nav1.9 sodium channel subunits have been discovered in SFN patients, enlarging the spectrum of underlying conditions. Sodium channel gene variants associated with SFN can lead to a diversity of phenotypes, including different pain distributions and presence or absence of autonomic symptoms. This suggests that SFN is part of a clinical continuum. New assessments might contribute to a better understanding of the cellular and molecular substrates of SFN and might provide improved diagnostic methods and trial designs in the future. Identification of the underlying mechanisms may inform the development of drugs that more effectively address neuropathic pain and autonomic symptoms of SFN.

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Small Fiber Neuropathy Following Vaccination

Cited by 29 publications

References 16 publications

Diagnostic utility of small fiber analysis in skin biopsies from children with chronic pain

Diagnostic utility of small fiber analysis in skin biopsies from children with chronic pain

Vaccine-induced autoimmunity: the role of molecular mimicry and immune crossreaction

Small‐fiber neuropathy: Expanding the clinical pain universe

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