A case of sudden death after Japanese encephalitis vaccination

Bunai, Yasuo; Ishii, Akira; Akaza, Kayoko; Nagai, Atsushi; Nishida, Naoki; Yamaguchi, Seiji

doi:10.1016/j.legalmed.2015.03.003

Cited by 5 publications

(3 citation statements)

References 35 publications

(35 reference statements)

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“…In addition, JE vaccines have been reported to be linked to some fatal or serious events from the literature. A sudden death of a 10-year-old boy after JE vaccination was reported [ 31 ]. Several patients developed serious neurological symptoms within a few weeks after JE vaccination [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Anti-NMDA Receptor Encephalitis and Vaccination

Wang

2017

IJMS

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Anti-N-methyl-d-aspartate (Anti-NMDA) receptor encephalitis is an acute autoimmune neurological disorder. The cause of this disease is often unknown, and previous studies revealed that it might be caused by a virus, vaccine or tumor. It occurs more often in females than in males. Several cases were reported to be related to vaccination such as the H1N1 vaccine and tetanus/diphtheria/pertussis and polio vaccines. In this study, we reported an anti-NMDA receptor encephalitis case that may be caused by Japanese encephalitis vaccination. To investigate the association between anti-NMDA receptor encephalitis and vaccination, we analyzed the phylogenetic relationship of the microRNAs, which significantly regulate these vaccine viruses or bacteria, and the phylogenetic relationship of these viruses and bacteria. This reveals that anti-NMDA receptor encephalitis may be caused by Japanese encephalitis vaccination, as well as H1N1 vaccination or tetanus/diphtheria/pertussis and polio vaccinations, from the phylogenetic viewpoint.

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Section: Discussionmentioning

confidence: 99%

Anti-NMDA Receptor Encephalitis and Vaccination

Wang

2017

IJMS

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“…A case of cardiac arrest and death in a boy who was taking pimozide in combination with aripiprazole and sertraline has been reported. 35 Sertraline, an SSRI (antidepressant), has been reported to inhibit not only the hERG channels but also P-gp, including its metabolites. 36,37 It has been reported that blood levels of orally administered pimozide are increased by sertraline.…”

Section: Discussionmentioning

confidence: 99%

P‐Glycoprotein‐Mediated Interaction Is a Risk Factor for QT Prolongation in Concomitant Use of Antipsychotics and SSRIs as P‐Glycoprotein‐Mediated Inhibitors: Analysis of the Japanese Adverse Drug Event Report Database

Morishita,

Perera,

Sunakawa

et al. 2023

The Journal of Clinical Pharma

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Inhibition of human ether‐a‐go‐go‐related gene (hERG) channels is a known cause of QT prolongation by antipsychotic drugs. Our previous studies suggest that P‐glycoprotein (P‐gp)‐mediated drug interactions may lead to increased gastrointestinal absorption of pimozide and its accumulation in cardiomyocytes, thereby enhancing the inhibitory effect of hERG channels. There is a paucity of epidemiological studies examining the risk of QT prolongation by antipsychotic drugs in terms of P‐gp‐mediated interactions with concomitant drugs. Therefore, using the Japanese Adverse Event Reporting Database, we investigated whether the risk of QT prolongation with antipsychotic drugs with hERG inhibition is affected by concomitant use of selective serotonin reuptake inhibitors (SSRIs) with P‐gp inhibition. The results showed that the frequency of QT prolongation increased when the antipsychotic drugs quetiapine and sulpiride, which are P‐gp substrates, were combined with SSRIs with P‐gp inhibition. In contrast, no association with QT prolongation was observed in patients on non‐P‐gp‐substrate antipsychotics, irrespective of the P‐gp inhibitory effect of the concomitant SSRI. These results suggest that P‐gp‐mediated interactions are a risk factor for antipsychotic‐induced QT prolongation. There is a need for further investigation into the risks of specific drug combinations.This article is protected by copyright. All rights reserved

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“…For example, the combination of pimozide and sertraline is contraindicated because it leads to an increased blood concentration of pimozide [ 4 ], thus increasing the risk of QT prolongation. Nevertheless, a case has been reported in which a male child administered pimozide together with sertraline and aripiprazole died due to cardiac arrest in Japan [ 5 ]. There are several reasons why the blood concentration of pimozide may be elevated by sertraline and/or aripiprazole, but the precise mechanism of this drug-drug interaction is unclear.…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal absorption of pimozide is enhanced by inhibition of P-glycoprotein

et al. 2020

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Drug-drug interaction was suggested to have played a role in the recent death due to cardiac arrest of a patient taking pimozide, sertraline and aripiprazole antipsychotic/antidepressant combination therapy. Here, we investigated the possible involvement of P-glycoprotein (P-gp)-mediated interaction among these drugs, using in vitro methods. ATPase assay confirmed that pimozide is a P-gp substrate, and might act as a P-gp inhibitor at higher concentrations. The maximum transport rate ( J max ) and half-saturation concentration ( K t ) for the carrier-mediated transport estimated by means of pimozide efflux assay using P-gp-overexpressing LLC-GA5-CoL150 cells were 84.9 ± 8.9 pmol/min/mg protein, and 10.6 ± 4.7 μM, respectively. These results indicate that pimozide is a good P-gp substrate, and it appears to have the potential to cause drug-drug interactions in the digestive tract at clinically relevant gastrointestinal concentrations. Moreover, sertraline or aripiprazole significantly decreased the efflux ratio of pimozide in LLC-GA5-CoL150 cells. Transport studies using Caco-2 cell monolayers were consistent with the results in LLC-GA5-CoL150 cells, and indicate that P-gp-mediated drug-drug interaction may occur in the gastrointestinal tract. Thus, P-gp inhibition by sertraline and/or aripiprazole may increase the gastrointestinal permeability of co-administered pimozide, resulting in an increased blood concentration of pimozide, which is known to be associated with an increased risk of QT prolongation, a life-threatening side effect.

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A case of sudden death after Japanese encephalitis vaccination

Cited by 5 publications

References 35 publications

Anti-NMDA Receptor Encephalitis and Vaccination

Anti-NMDA Receptor Encephalitis and Vaccination

P‐Glycoprotein‐Mediated Interaction Is a Risk Factor for QT Prolongation in Concomitant Use of Antipsychotics and SSRIs as P‐Glycoprotein‐Mediated Inhibitors: Analysis of the Japanese Adverse Drug Event Report Database

Gastrointestinal absorption of pimozide is enhanced by inhibition of P-glycoprotein

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