Acute Disseminated Encephalomyelitis following vaccination against Human Papilloma Virus
RobertoBomprezzi, Barrow Neurological Institute, St. Joseph's Hospital Medical Center
Published September 16, 2009
Wildemann et al. present a case of aggressive ADEM following immunization with the polyvalent HPV vaccine. [1] The time between vaccine exposure and onset of illness provides evidence for a cause-effect relationship.
As the authors report, the immunological stimulus of several infectious agents and vaccines have been known to predispose to the development of ADEM. It is important to monitor the occurrence of immune-mediated diseases that are occurring after vaccination with Gardasil®, recently introduced into practice. [2-3] Two young females who had received the Gardasil® vaccine approximately one month previous presented to our clinics with a demyelinating syndrome that subsequently met criteria for multiple sclerosis (report submitted for publication).
I concur with Wildemann and co-authors that molecular mimicry may be the basis for the activation of a cross-reactive immune-response and it is possible that—depending on the individual predisposition—either a monophasic CNS disease or a relapsing-remitting typical demyelinating syndrome ensues.
I feel it is appropriate to increase awareness on the potential risks for serious complications of this new medical preside.
References
1.Wildemann B, Jarius S, Hartmann M, Regula JU, Hametner C. Acute disseminated encephalomyelitis following vaccination against human papilloma virus. Neurology 2009;72;2132-2133.
2. Sutton I, Lahoria R, Tan I, Clouston P, Barnett M. CNS demyelination and quadrivalent HPV vaccination. Mult Scler 2009;15:116–119.
3. Douglas RJ. Quadrivalent HPV vaccination reactions--more hype than harm. Aust Fam Physician 2009; 38:139-142.
Disclosure: Dr. Bomprezzi has served as principal investigator for clinical trials supported by Genzyme Corporation, Novartis, Serono International, Biogen Idec, Genentech Inc, and UCB Pharma Inc.
Wildemann et al. present a case of aggressive ADEM following immunization with the polyvalent HPV vaccine. [1] The time between vaccine exposure and onset of illness provides evidence for a cause-effect relationship.
As the authors report, the immunological stimulus of several infectious agents and vaccines have been known to predispose to the development of ADEM. It is important to monitor the occurrence of immune-mediated diseases that are occurring after vaccination with Gardasil®, recently introduced into practice. [2-3] Two young females who had received the Gardasil® vaccine approximately one month previous presented to our clinics with a demyelinating syndrome that subsequently met criteria for multiple sclerosis (report submitted for publication).
I concur with Wildemann and co-authors that molecular mimicry may be the basis for the activation of a cross-reactive immune-response and it is possible that—depending on the individual predisposition—either a monophasic CNS disease or a relapsing-remitting typical demyelinating syndrome ensues.
I feel it is appropriate to increase awareness on the potential risks for serious complications of this new medical preside.
References
1.Wildemann B, Jarius S, Hartmann M, Regula JU, Hametner C. Acute disseminated encephalomyelitis following vaccination against human papilloma virus. Neurology 2009;72;2132-2133.
2. Sutton I, Lahoria R, Tan I, Clouston P, Barnett M. CNS demyelination and quadrivalent HPV vaccination. Mult Scler 2009;15:116–119.
3. Douglas RJ. Quadrivalent HPV vaccination reactions--more hype than harm. Aust Fam Physician 2009; 38:139-142.
Disclosure: Dr. Bomprezzi has served as principal investigator for clinical trials supported by Genzyme Corporation, Novartis, Serono International, Biogen Idec, Genentech Inc, and UCB Pharma Inc.