Section of Pediatrics, Department of Medicine, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka 814-0193, Japan.
Division of Basic Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka 814-0193, Japan.
Vaccine. 2019 Feb 14;37(8):1126-1129. doi: 10.1016/j.vaccine.2019.01.021. Epub 2019 Jan 23.
While the basic definition of vaccination-associated acute disseminated encephalomyelitis (ADEM) is relatively clear and easily understandable, it is often difficult to diagnose ADEM based on clinical findings alone. ADEM is actually a heterogeneous clinical syndrome that can be approximately characterized by encephalomyelitis with multiple inflammatory demyelination, autoimmune causes, and relationship with a preceding infection or vaccination. The differential diagnosis of ADEM should exclude the possibility of infectious or other autoimmune encephalitis. The occurrence of vaccination-associated ADEM is influenced by several factors including the health and ethnic status of the vaccinated individual, vaccine components, and environment. Cases suspected of vaccination-associated ADEM should be analyzed cautiously from multi-disciplinary perspectives.
虽然接种相关急性播散性脑脊髓炎(ADEM)的基本定义相对明确且易于理解,但仅根据临床发现诊断 ADEM 往往具有挑战性。ADEM 实际上是一种异质性临床综合征,可大致表现为多发性炎症性脱髓鞘性脑脊髓炎、自身免疫病因以及与前驱感染或疫苗接种的关系。ADEM 的鉴别诊断应排除感染性或其他自身免疫性脑炎的可能性。接种相关 ADEM 的发生受多种因素影响,包括接种个体的健康和种族状况、疫苗成分和环境。疑似接种相关 ADEM 的病例应从多学科角度谨慎分析。