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Silvia Polívková1, Lenka Vojtilová, Petr Husa
1Department of Inectious Diseases, 3rd Medical faculty, Charles University, Prague, Hospital na Bulovce, Czech Republic,
Abstract:
We present a case of a 17-year-old female with anti-NMDAR encephalitis probably associated with vaccination against yellow fever. Her symptoms occurred 27 days after vaccination against yellow fever. Anti-NMDAR encephalitis manifested as acute psychosis, memory loss and catatonia following fever with complex partial epileptic seizures. Interictal electroencephalogram showed slow-wave delta background activity with "delta brushes". The diagnosis was confirmed by NMDAR antibody positivity in serum and cerebrospinal fluid. Since ovarian teratoma, as the most common cause of anti-NMDAR encephalitis, did not develop within five years from its onset, the association with vaccination against yellow fever seems to be highly probable.
Insights
A rare case of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis occurred in a young female 27 days post-yellow fever vaccination. This suggests a potential link between the vaccine and the neurological autoimmune disorder.
Area of Science:
- Neurology
- Immunology
- Vaccinology
Background:
- Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe autoimmune neurological disorder.
- It is often associated with ovarian teratomas but can have other triggers.
- Vaccine-induced autoimmunity is a recognized but uncommon phenomenon.
Observation:
- A 17-year-old female developed acute psychosis, memory loss, catatonia, and seizures 27 days after yellow fever vaccination.
- Electroencephalogram revealed characteristic "delta brushes."
- NMDAR antibodies were detected in serum and cerebrospinal fluid.
Findings:
- The patient's symptoms strongly indicated anti-NMDAR encephalitis.
- The absence of an ovarian teratoma and the temporal association with vaccination suggest a probable link to yellow fever immunization.
- This case highlights a potential adverse event following immunization.
Implications:
- This case suggests that yellow fever vaccination may be a potential trigger for anti-NMDAR encephalitis.
- Further research is needed to investigate the immunogenicity of the yellow fever vaccine and its potential role in autoimmune encephalitis.
- Understanding vaccine-associated neurological events is crucial for vaccine safety monitoring and public health.
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