Simultaneous Development of Acute Disseminated Encephalomyelitis and Guillain-Barré Syndrome Associated with H1N1 09 Influenza Vaccination

• Published in: Internal Medicine Vol. 51; no. 12; pp. 1595 - 1598
• Main Authors: Hoshino, Takao, Uchiyama, Yumiko, Ito, Eiichi, Osawa, Shunsuke, Ohashi, Takashi
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2012
• Subjects: acute disseminated encephalomyelitis; Adult; anti-ganglioside antibody; Autoantibodies - blood; Encephalomyelitis, Acute Disseminated - diagnosis; Encephalomyelitis, Acute Disseminated - etiology; Encephalomyelitis, Acute Disseminated - immunology; G(M2) Ganglioside - immunology; GM2 ganglioside; Guillain-Barre Syndrome - diagnosis; Guillain-Barre Syndrome - etiology; Guillain-Barre Syndrome - immunology; Guillain-Barré syndrome; Humans; Influenza A Virus, H1N1 Subtype; influenza vaccination; Influenza Vaccines - adverse effects; Magnetic Resonance Imaging; Male
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.51.7132

A 36-year-old man was admitted to our hospital because of urinary retention and muscle weakness affecting all 4 limbs after receiving a H1N1 09 influenza vaccination. Magnetic resonance imaging demonstrated multiple lesions in his brain and spinal cord. Furthermore, nerve conduction study showed acute sensorimotor neuropathy, and anti-GM2 antibodies were detected in his serum. Based on the temporal association and exclusion of alternative etiologies, we made a diagnosis of acute disseminated encephalomyelitis (ADEM) and Guillain-Barré syndrome (GBS). To our knowledge, this is the first case of co-morbid ADEM and GBS after influenza vaccination with positive anti-ganglioside antibodies.