Pediatric Acute Disseminated Encephalomyelitis Triggered by Concurrent Administration of Seasonal and H1N1 Influenza Vaccines: A Case Report and Review

Background: Acute disseminated encephalomyelitis (ADEM) is a rare, immune-mediated inflammatory disorder of the central nervous system (CNS), typically characterized by the acute onset of multifocal demyelination. The pathogenesis of ADEM remains unclear, but it is believed to be triggered by an aut...

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Main Authors: George Imataka, Hideaki Shiraishi, Shigemi Yoshihara
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:NeuroSci
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Online Access:https://www.mdpi.com/2673-4087/6/1/1
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author George Imataka
Hideaki Shiraishi
Shigemi Yoshihara
author_facet George Imataka
Hideaki Shiraishi
Shigemi Yoshihara
author_sort George Imataka
collection DOAJ
description Background: Acute disseminated encephalomyelitis (ADEM) is a rare, immune-mediated inflammatory disorder of the central nervous system (CNS), typically characterized by the acute onset of multifocal demyelination. The pathogenesis of ADEM remains unclear, but it is believed to be triggered by an autoimmune response, often following viral infections or vaccinations. Case report: This case report describes a 3-year-old child who developed ADEM after receiving two concurrent influenza vaccines: one for seasonal influenza and one for the 2009 H1N1 pandemic. The patient presented with motor regression, mild pleocytosis in cerebrospinal fluid (CSF), and typical MRI findings of ADEM. Steroid pulse therapy resulted in rapid improvement, and the patient recovered fully without sequelae. Results: Although the influenza vaccine has been linked to ADEM in some studies, it remains uncertain whether the simultaneous administration of both vaccines contributed to the onset of ADEM. While influenza vaccines are considered safe and effective by health organizations such as the CDC, data suggest that the incidence of ADEM and other neurological complications is significantly higher after natural influenza infections compared to vaccination. This highlights the importance of vaccination in preventing severe outcomes. Conclusions: This case underscores the importance of monitoring and reporting adverse events following vaccination to refine our understanding of rare complications like ADEM. While simultaneous vaccine administration warrants further research, the benefits of vaccination in preventing severe complications from natural infections far outweigh the risks. Continued vigilance and improved surveillance systems are essential for maintaining public confidence in vaccination programs.
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spelling doaj-art-7e737075fb1e45e8abc73043b77f0dc42025-08-20T02:42:23ZengMDPI AGNeuroSci2673-40872024-12-0161110.3390/neurosci6010001Pediatric Acute Disseminated Encephalomyelitis Triggered by Concurrent Administration of Seasonal and H1N1 Influenza Vaccines: A Case Report and ReviewGeorge Imataka0Hideaki Shiraishi1Shigemi Yoshihara2Department of Pediatrics, Dokkyo Medical University, Tochigi 321-0293, JapanDepartment of Pediatrics, Dokkyo Medical University, Tochigi 321-0293, JapanDepartment of Pediatrics, Dokkyo Medical University, Tochigi 321-0293, JapanBackground: Acute disseminated encephalomyelitis (ADEM) is a rare, immune-mediated inflammatory disorder of the central nervous system (CNS), typically characterized by the acute onset of multifocal demyelination. The pathogenesis of ADEM remains unclear, but it is believed to be triggered by an autoimmune response, often following viral infections or vaccinations. Case report: This case report describes a 3-year-old child who developed ADEM after receiving two concurrent influenza vaccines: one for seasonal influenza and one for the 2009 H1N1 pandemic. The patient presented with motor regression, mild pleocytosis in cerebrospinal fluid (CSF), and typical MRI findings of ADEM. Steroid pulse therapy resulted in rapid improvement, and the patient recovered fully without sequelae. Results: Although the influenza vaccine has been linked to ADEM in some studies, it remains uncertain whether the simultaneous administration of both vaccines contributed to the onset of ADEM. While influenza vaccines are considered safe and effective by health organizations such as the CDC, data suggest that the incidence of ADEM and other neurological complications is significantly higher after natural influenza infections compared to vaccination. This highlights the importance of vaccination in preventing severe outcomes. Conclusions: This case underscores the importance of monitoring and reporting adverse events following vaccination to refine our understanding of rare complications like ADEM. While simultaneous vaccine administration warrants further research, the benefits of vaccination in preventing severe complications from natural infections far outweigh the risks. Continued vigilance and improved surveillance systems are essential for maintaining public confidence in vaccination programs.https://www.mdpi.com/2673-4087/6/1/1ADEMMRIchildinfluenza vaccineH1N1immunological response
spellingShingle George Imataka
Hideaki Shiraishi
Shigemi Yoshihara
Pediatric Acute Disseminated Encephalomyelitis Triggered by Concurrent Administration of Seasonal and H1N1 Influenza Vaccines: A Case Report and Review
NeuroSci
ADEM
MRI
child
influenza vaccine
H1N1
immunological response
title Pediatric Acute Disseminated Encephalomyelitis Triggered by Concurrent Administration of Seasonal and H1N1 Influenza Vaccines: A Case Report and Review
title_full Pediatric Acute Disseminated Encephalomyelitis Triggered by Concurrent Administration of Seasonal and H1N1 Influenza Vaccines: A Case Report and Review
title_fullStr Pediatric Acute Disseminated Encephalomyelitis Triggered by Concurrent Administration of Seasonal and H1N1 Influenza Vaccines: A Case Report and Review
title_full_unstemmed Pediatric Acute Disseminated Encephalomyelitis Triggered by Concurrent Administration of Seasonal and H1N1 Influenza Vaccines: A Case Report and Review
title_short Pediatric Acute Disseminated Encephalomyelitis Triggered by Concurrent Administration of Seasonal and H1N1 Influenza Vaccines: A Case Report and Review
title_sort pediatric acute disseminated encephalomyelitis triggered by concurrent administration of seasonal and h1n1 influenza vaccines a case report and review
topic ADEM
MRI
child
influenza vaccine
H1N1
immunological response
url https://www.mdpi.com/2673-4087/6/1/1
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AT hideakishiraishi pediatricacutedisseminatedencephalomyelitistriggeredbyconcurrentadministrationofseasonalandh1n1influenzavaccinesacasereportandreview
AT shigemiyoshihara pediatricacutedisseminatedencephalomyelitistriggeredbyconcurrentadministrationofseasonalandh1n1influenzavaccinesacasereportandreview