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Post-vaccination MDEM associated with MOG antibody in a subclinical Chlamydia infected boy.
Brain Dev. 2016 Aug; 38(7):690-3.BD

Abstract

The mechanism of post-vaccination acute disseminated encephalomyelitis (ADEM) has been hypothesized as resulting from vaccination-injected antigens cross-reacting with myelin components, however, a precise etiology has been uncertain. In this report, we describe the case of a 6-year-old Japanese boy who had multiphasic disseminated encephalomyelitis (MDEM), and was positive for both anti-myelin oligodendrocyte glycoprotein (MOG) antibodies and Chlamydophila pneumoniae antibodies. After vaccinations that were the second one for measles and rubella, and the booster immunization for Japanese encephalitis, the patient presented with fever, headache, vomiting, and a change in personality. He was treated with a high-dose of intravenous methylprednisolone in the diagnosis of ADEM. However, these symptoms recurred with different magnetic resonance imaging lesion, and he was diagnosed as MDEM. Retrospective testing for pathogens revealed C. pneumoniae IgM and IgG antibodies, and it was considered that he was infected with C. pneumoniae subclinically. The patient's serum indicated a positive response for the anti-MOG antibody from the onset of the ADEM diagnosis and in all recurrent episodes. Chlamydia species infection has been known to play a role in demyelinating diseases. It is also known that the anti-MOG antibody may be present but not exhibit its pathogenesis in the absence of a cell-mediated inflammatory response; however, the precise mechanism of action of the anti-MOG antibodies is not yet determined. We propose the possibility that post-vaccination demyelinating disease may result from the synergistic effects of a preceding anti-MOG antibody, possibly produced in response to a subclinical Chlamydia species infection.

Authors+Show Affiliations

Department of Pediatrics, Seikeikai Hospital, Osaka, Japan; Health Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Osaka, Japan. Electronic address: azumagawa@seikeikai.or.jp.Department of Pediatrics, Seikeikai Hospital, Osaka, Japan.Health Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Osaka, Japan.Appalachian State University, Boone, NC, USA.Tohoku University Graduate School of Medicine, Miyagi, Japan.Tohoku University Graduate School of Medicine, Miyagi, Japan.Department of Pediatric Neurology, Hirakata Municipal Hospital, Osaka, Japan.Department of Pediatric Neurology, Tanabe Children's Clinic, Osaka, Japan.Osaka Medical College, Osaka, Japan.Osaka Medical College, Osaka, Japan.Osaka Medical College, Osaka, Japan.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

26922251

Citation

Azumagawa, Kohji, et al. "Post-vaccination MDEM Associated With MOG Antibody in a Subclinical Chlamydia Infected Boy." Brain & Development, vol. 38, no. 7, 2016, pp. 690-3.
Azumagawa K, Nomura S, Shigeri Y, et al. Post-vaccination MDEM associated with MOG antibody in a subclinical Chlamydia infected boy. Brain Dev. 2016;38(7):690-3.
Azumagawa, K., Nomura, S., Shigeri, Y., Jones, L. S., Sato, D. K., Nakashima, I., Kashiwagi, M., Tanabe, T., Shimakawa, S., Nakajima, H., & Tamai, H. (2016). Post-vaccination MDEM associated with MOG antibody in a subclinical Chlamydia infected boy. Brain & Development, 38(7), 690-3. https://doi.org/10.1016/j.braindev.2016.02.004
Azumagawa K, et al. Post-vaccination MDEM Associated With MOG Antibody in a Subclinical Chlamydia Infected Boy. Brain Dev. 2016;38(7):690-3. PubMed PMID: 26922251.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Post-vaccination MDEM associated with MOG antibody in a subclinical Chlamydia infected boy. AU - Azumagawa,Kohji, AU - Nomura,Shohei, AU - Shigeri,Yasushi, AU - Jones,Leslie Sargent, AU - Sato,Douglas Kazutoshi, AU - Nakashima,Ichiro, AU - Kashiwagi,Mitsuru, AU - Tanabe,Takuya, AU - Shimakawa,Shuichi, AU - Nakajima,Hideto, AU - Tamai,Hiroshi, Y1 - 2016/02/24/ PY - 2015/11/20/received PY - 2016/02/08/revised PY - 2016/02/09/accepted PY - 2016/2/29/entrez PY - 2016/2/29/pubmed PY - 2017/1/14/medline KW - Chlamydia KW - Multiphasic disseminated encephalomyelitis (MDEM) KW - Myelin oligodendrocyte glycoprotein (MOG) KW - Vaccine SP - 690 EP - 3 JF - Brain & development JO - Brain Dev VL - 38 IS - 7 N2 - The mechanism of post-vaccination acute disseminated encephalomyelitis (ADEM) has been hypothesized as resulting from vaccination-injected antigens cross-reacting with myelin components, however, a precise etiology has been uncertain. In this report, we describe the case of a 6-year-old Japanese boy who had multiphasic disseminated encephalomyelitis (MDEM), and was positive for both anti-myelin oligodendrocyte glycoprotein (MOG) antibodies and Chlamydophila pneumoniae antibodies. After vaccinations that were the second one for measles and rubella, and the booster immunization for Japanese encephalitis, the patient presented with fever, headache, vomiting, and a change in personality. He was treated with a high-dose of intravenous methylprednisolone in the diagnosis of ADEM. However, these symptoms recurred with different magnetic resonance imaging lesion, and he was diagnosed as MDEM. Retrospective testing for pathogens revealed C. pneumoniae IgM and IgG antibodies, and it was considered that he was infected with C. pneumoniae subclinically. The patient's serum indicated a positive response for the anti-MOG antibody from the onset of the ADEM diagnosis and in all recurrent episodes. Chlamydia species infection has been known to play a role in demyelinating diseases. It is also known that the anti-MOG antibody may be present but not exhibit its pathogenesis in the absence of a cell-mediated inflammatory response; however, the precise mechanism of action of the anti-MOG antibodies is not yet determined. We propose the possibility that post-vaccination demyelinating disease may result from the synergistic effects of a preceding anti-MOG antibody, possibly produced in response to a subclinical Chlamydia species infection. SN - 1872-7131 UR - https://www.unboundmedicine.com/medline/citation/26922251/Post_vaccination_MDEM_associated_with_MOG_antibody_in_a_subclinical_Chlamydia_infected_boy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0387-7604(16)00030-9 DB - PRIME DP - Unbound Medicine ER -