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病例报告:人乳头瘤病毒疫苗接种后抗谷氨酸脱羧酶65抗体相关的自身免疫性脑炎

Case report: Anti-GAD65 antibody-associated autoimmune encephalitis following HPV vaccination.

作者信息

Li Aonan, Hu Ying, Li Jialu, Chen Xingui, Jiang Yubao, Xie Chengjuan

机构信息

Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.

出版信息

Front Neurol. 2022 Oct 5;13:1017086. doi: 10.3389/fneur.2022.1017086. eCollection 2022.

Abstract

Human papillomavirus (HPV) infection is a sexually transmitted disease that may lead to cervical cancer. HPV vaccines have been implemented widely to prevent this. While generally few complications of vaccination are reported, there have been occasional reports of adverse reactions post-vaccination. The safety profile of the HPV vaccine is reassuring. However, since its introduction, several serious post-vaccination central nervous system complications have been reported; however, causality has not been established. Herein, we describe a 39-year-old woman who developed seizures and experienced a rapid decline in memory shortly after her first dose of the HPV vaccine. Cranial magnetic resonance imaging and cerebrospinal fluid analysis were performed, and the patient was diagnosed with anti-glutamic acid decarboxylase 65 (anti-GAD65) antibody-associated autoimmune encephalitis. She responded well to high-dose glucocorticoids. Four-month follow-up revealed full recovery and absence of recurrence. Since the HPV vaccine is administered worldwide, this case should raise clinicians' awareness regarding the possible CNS complications related to vaccinations, such as anti-GAD65 antibody-associated AE.

摘要

人乳头瘤病毒(HPV)感染是一种性传播疾病,可能导致宫颈癌。HPV疫苗已被广泛应用以预防此病。虽然一般报告的疫苗接种并发症较少,但偶尔也有接种后不良反应的报告。HPV疫苗的安全性令人放心。然而,自其引入以来,已有数例接种后严重中枢神经系统并发症的报告;然而,因果关系尚未确立。在此,我们描述一名39岁女性,在接种第一剂HPV疫苗后不久出现癫痫发作,并经历记忆力迅速下降。进行了头颅磁共振成像和脑脊液分析,该患者被诊断为抗谷氨酸脱羧酶65(抗GAD65)抗体相关的自身免疫性脑炎。她对大剂量糖皮质激素反应良好。四个月的随访显示完全康复且无复发。由于HPV疫苗在全球范围内接种,该病例应提高临床医生对与疫苗接种相关的可能的中枢神经系统并发症的认识,如抗GAD65抗体相关的自身免疫性脑炎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0872/9579373/545e8493677f/fneur-13-1017086-g0001.jpg

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