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[Acute disseminated encephalomyelitis and meningococcal A and C vaccine: case report]
1Serviço de Neurologia, Hospital Universitário Clementino Fraga Filho, Rio de Janeiro RJ, Brasil.
Abstract:
A 25-year-old women developed acute disseminated post-vaccinal encephalomyelitis (ADEM) following vaccination with A plus C meningococcal vaccine (Pasteur-Merieux). Fast disappearance of symptoms and gradual resolution of MRI demyelinating lesions occurred after steroid treatment with high doses of intravenous methylprednisolone. To our knowledge, ADEM has not been previously described in association with meningococcal vaccine. Although most cases of ADEM occur following viral infections and vaccination, the syndrome has previously been related to leptospirosis and Mycoplasma pneumoniae infections. This suggests that it may also be related to exposure to polysaccharide-protein vaccines such as the Group A plus Group C meningococcal vaccine.
Insights
Acute disseminated encephalomyelitis (ADEM) is a rare neurological condition that can occur after vaccination. This case report details a patient who developed ADEM following meningococcal vaccination, with symptoms resolving after steroid treatment.
Area of Science:
- Neurology
- Immunology
- Vaccinology
Background:
- Acute disseminated encephalomyelitis (ADEM) is an immune-mediated inflammatory demyelinating disease of the central nervous system.
- While often post-infectious, ADEM can also be triggered by vaccination, typically with live-attenuated vaccines.
- Meningococcal vaccines are generally safe, with neurological adverse events being rare.
Observation:
- A 25-year-old woman developed ADEM following vaccination with a Group A and C meningococcal vaccine.
- Clinical symptoms of ADEM included neurological deficits.
- Magnetic resonance imaging (MRI) revealed demyelinating lesions in the brain.
Findings:
- The patient's ADEM symptoms showed rapid improvement.
- High-dose intravenous methylprednisolone treatment led to gradual resolution of MRI-detected demyelinating lesions.
- This represents the first reported case of ADEM associated with meningococcal vaccination.
Implications:
- The findings suggest a potential link between polysaccharide-protein conjugate vaccines, such as the meningococcal vaccine, and the development of ADEM.
- This case expands the spectrum of known vaccine triggers for ADEM.
- Further investigation is warranted to understand the immunological mechanisms underlying ADEM following meningococcal vaccination.