Bensaidane Mohamed Reda, Picher-Martel Vincent, Émond François, De Serres Gaston, Dupré Nicolas, Beauchemin Philippe
Department of Medicine, Faculty of Medicine, Centre Hospitalier Universitaire de Québec-Université Laval, Quebec, QC, Canada.
Department of Psychiatry and Neuroscience, Faculty of Medicine, CERVO Brain Research Centre, Quebec, QC, Canada.
Front Neurol. 2022 Apr 29;13:872734. doi: 10.3389/fneur.2022.872734. eCollection 2022.
Acute necrotizing encephalopathy (ANE) is a rare neurological disorder arising from a para- or post-infectious "cytokine storm. "It has recently been reported in association with coronavirus disease 2019 (COVID-19) infection.
A 56-year-old male with a diagnosis of ANE 48 h following the first dose of ChAdOx1 nCoV-19 vaccination was investigated. Cytokine analyses on serum and cerebrospinal fluid (CSF) were performed. The patient was treated with high-dose corticosteroids and followed clinically and radiologically.
Favorable clinical and radiological outcomes were noted. There was an upregulation in serum levels of CXCL5, CXCL1, Il-8, IL-15, CCL2, TGF-B, and EGF, and up-regulation in CSF levels of CXCL5, IL-2, IL-3, and IL-8.
As COVID-19 infection has been previously reported as a possible rare cause of ANE, we speculate on an aberrant immune response mechanism that was brought about by the vaccine. To increase our understanding of the pathogenesis of ANE in the context of COVID-19 vaccination and to better define its clinical features and outcomes, clinicians and scientists should continue reporting convincing cases of such entities.
急性坏死性脑病（ANE）是一种罕见的神经系统疾病，由感染期间或感染后出现的“细胞因子风暴”引起。最近有报道称其与2019冠状病毒病（COVID-19）感染有关。
对一名56岁男性进行了调查，该患者在接种第一剂ChAdOx1 nCoV-19疫苗48小时后被诊断为ANE。对血清和脑脊液（CSF）进行了细胞因子分析。患者接受了大剂量皮质类固醇治疗，并进行了临床和影像学随访。
观察到良好的临床和影像学结果。血清中CXCL5、CXCL1、Il-8、IL-15、CCL2、TGF-B和EGF水平上调，脑脊液中CXCL5、IL-2、IL-3和IL-8水平上调。
由于先前已报道COVID-19感染是ANE的一种可能的罕见病因，我们推测疫苗引发了异常的免疫反应机制。为了增进我们对COVID-19疫苗接种背景下ANE发病机制的理解，并更好地界定其临床特征和结局，临床医生和科学家应继续报告此类令人信服的病例。
