{"title":"急性播散性脑脊髓炎的老年患者肺炎球菌接种后脑脊液白细胞介素‐6极高","authors":"Yuu-ichi Kira, Takumi Tashiro, Norihisa Maeda","doi":"10.1111/cen3.12719","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Postvaccination acute disseminated encephalomyelitis (ADEM) may develop 2–30 days after vaccination. However, ADEM following pneumococcal vaccination has never been reported.</p>\n </section>\n \n <section>\n \n <h3> Case presentation</h3>\n \n <p>We report a 73-year-old woman with ADEM following pneumococcal vaccination. She developed acute fever and consciousness disturbance 17 days after the second administration of 23-valent pneumococcal polysaccharide vaccine (PPSV23). Head magnetic resonance imaging (MRI) revealed numerous T2-high lesions, mainly involving the cerebral and cerebellar white matter and brainstem. Cerebrospinal fluid examination showed polymorphonuclear pleocytosis and markedly elevated interleukin-6 (58,400 pg/ml). Her symptoms and MRI lesions were promptly resolved by steroid pulse therapy, with no relapse.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Although PPSV23 is recommended for elderly individuals, this case highlights the risk of ADEM caused by unexpected immune activation following repeated administration of the vaccine.</p>\n </section>\n </div>","PeriodicalId":10193,"journal":{"name":"Clinical and Experimental Neuroimmunology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen3.12719","citationCount":"1","resultStr":"{\"title\":\"Acute disseminated encephalomyelitis in an elderly patient following pneumococcal vaccination with extremely high cerebrospinal fluid interleukin-6\",\"authors\":\"Yuu-ichi Kira, Takumi Tashiro, Norihisa Maeda\",\"doi\":\"10.1111/cen3.12719\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Postvaccination acute disseminated encephalomyelitis (ADEM) may develop 2–30 days after vaccination. However, ADEM following pneumococcal vaccination has never been reported.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Case presentation</h3>\\n \\n <p>We report a 73-year-old woman with ADEM following pneumococcal vaccination. She developed acute fever and consciousness disturbance 17 days after the second administration of 23-valent pneumococcal polysaccharide vaccine (PPSV23). Head magnetic resonance imaging (MRI) revealed numerous T2-high lesions, mainly involving the cerebral and cerebellar white matter and brainstem. Cerebrospinal fluid examination showed polymorphonuclear pleocytosis and markedly elevated interleukin-6 (58,400 pg/ml). Her symptoms and MRI lesions were promptly resolved by steroid pulse therapy, with no relapse.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Although PPSV23 is recommended for elderly individuals, this case highlights the risk of ADEM caused by unexpected immune activation following repeated administration of the vaccine.</p>\\n </section>\\n </div>\",\"PeriodicalId\":10193,\"journal\":{\"name\":\"Clinical and Experimental Neuroimmunology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-07-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen3.12719\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical and Experimental Neuroimmunology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/cen3.12719\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Immunology and Microbiology\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Experimental Neuroimmunology","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/cen3.12719","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Immunology and Microbiology","Score":null,"Total":0}
Acute disseminated encephalomyelitis in an elderly patient following pneumococcal vaccination with extremely high cerebrospinal fluid interleukin-6
Background
Postvaccination acute disseminated encephalomyelitis (ADEM) may develop 2–30 days after vaccination. However, ADEM following pneumococcal vaccination has never been reported.
Case presentation
We report a 73-year-old woman with ADEM following pneumococcal vaccination. She developed acute fever and consciousness disturbance 17 days after the second administration of 23-valent pneumococcal polysaccharide vaccine (PPSV23). Head magnetic resonance imaging (MRI) revealed numerous T2-high lesions, mainly involving the cerebral and cerebellar white matter and brainstem. Cerebrospinal fluid examination showed polymorphonuclear pleocytosis and markedly elevated interleukin-6 (58,400 pg/ml). Her symptoms and MRI lesions were promptly resolved by steroid pulse therapy, with no relapse.
Conclusion
Although PPSV23 is recommended for elderly individuals, this case highlights the risk of ADEM caused by unexpected immune activation following repeated administration of the vaccine.
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