Acute disseminated encephalomyelitis following 2009 H1N1 influenza vaccine

Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan.
Pediatrics International (Impact Factor: 0.73). 08/2012; 54(4):539-41. DOI: 10.1111/j.1442-200X.2011.03501.x
Source: PubMed


Acute disseminated encephalomyelitis (ADEM) is an immune-mediated inflammatory disorder of the central nervous system. We describe a previously healthy 2-year-old boy with ADEM, who exhibited high fever, lethargy, and recurrent seizures at 25 days after H1N1 influenza vaccination. To our knowledge, there has been only one report of ADEM following the 2009 H1N1 influenza vaccine, although such vaccination is accompanied with optic neuritis apart from this case. Thus, this is the first case of ADEM without optic neuritis, following the 2009 H1N1 influenza vaccination. Although vaccine-associated ADEM remains rare, the increasing number of influenza vaccinations might increase the incidence of ADEM. We still need to pay attention to the occurrence of ADEM and treat patients with steroid therapy.

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    • "None NS Recovered completely Yang et al. 2010 [28] 4 40 Y, M Infection ADEM 1 m None Oseltamivir Valproic acid Plasmapheresis Methylprednisolone Severely disabled state Fugate et al. 2010 [16] 5 38 Y, M Vaccination ADEM 10 d None Methylprednisolone Recovered completely Denholm et al. 2010 [14] 6 19 Y, F Vaccination ADEM 21 d None Methylprednisolone Persistent paresthesia Denholm et al. 2010 [14] 7 22 Y, M Infection ADEM 3 d None J-globulins Methylprednisolone Oseltamivir Recovered completely Wang et al. 2011 [27] 8 77 Y, F Vaccination TM 1 d Rectal cancer Immunoglobulins Methylprednisolone Severe neurological damage Sato et al. 2011 [25] 9 5 Y, M Vaccination ADEM 2 d None Corticosteroids Unknown Fernandes and Marchiori 2011 [15] 10 14 Y, M Infection TM 2 w None NS Recovered completely Landau et al. 2011 [20] 11 6 Y, M Infection ADEM 2 d None Oseltamivir Immunoglobulins Acyclovir Midazolam Phenytoin Recovered completely Yildizdas et al. 2011 [29] 12 34 m, M Vaccination ADEM 5 d None Dexamethasone Recovered completely Lee et al. 2011 [22] 13 13 Y, M Vaccination TM 6 d None Methylprednisolone Physical therapy Acupuncture (Moderate??) neurological damage Gui et al. 2011 [4] 14 44 Y, M Vaccination TM 1 m None Methylprednisolone Recovered completely Korn-Lubetzki et al. 2011 [19] 15 ?, F Vaccination TM 4 d None ? Unknown Arcondo et al. 2011 [12] 16 36 Y, M Vaccination ADEM & GBS 10 d None Methylprednisolone Persistent mild weakness and numbness of the distal extremities Hoshino et al. 2012 [18] 17 60 Y, M Infection ADEM 25 d None Osteltamavir Methylprednisolone 1 g 5 d Prednisolone 60 mg Recovered completely Athauda et al. 2012 [13] 18 2 Y, M Vaccination ADEM 25 d None Methylprednisolone Recovered completely Fujii et al. 2012 [17] 19 33 Y, F Vaccination ADEM 15 d None Methylprednisolone IV Prednisolone PO Recovered completely Maeda and Idehara 2012 [23] 20 7 Y, M Infection ADEM 5 d None Acyclovir Ceftriaxone Oseltamivir Methylprednisolone Prednisone Immunoglobulin IV Anarthria Quadriparesis Ozkale et al. 2012 [24] 21 52 Y, M Vaccination TM 7 d None ? Vieira et al. 2012 [26] 22 26 Y, F Vaccination ADEM 5 d Hypertension Acyclovir Corticosteroids Plasmapheresis Decompressive craniotomy Drainage of cerebrospinal fluid Persistent vegetative state Van Ussel et al. (This Study) "
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