<scp>P</scp>ostural tachycardia syndrome following human papillomavirus vaccination

Blitshteyn, Svetlana

doi:10.1111/ene.12272

Cited by 82 publications

(54 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These studies were prompted by the burden of reports regarding syncope, asthenia and pain syndromes occurring after HPV immunization [46, 47]. Recently, Martinez-Lavin published an interesting clinical report where two girls have developed severe incapacitating fibromyalgia-like illness, after one and two doses of HPV inoculation, respectively [48].…”

Section: Discussionmentioning

confidence: 99%

Severe somatoform and dysautonomic syndromes after HPV vaccination: case series and review of literature

et al. 2016

View full text Add to dashboard Cite

Human papilloma virus (HPV) is recognized as a major cause for cervical cancer among women worldwide. Two HPV vaccines are currently available: Gardasil® and Cervarix®. Both vaccines enclose viral antigenic proteins, but differ as to the biological systems of culture and the adjuvant components. Recently, a collection of symptoms, indicating nervous system dysfunction, has been described after HPV vaccination. We retrospectively described a case series including 18 girls (aged 12–24 years) referred to our “Second Opinion Medical Network” for the evaluation of “neuropathy with autonomic dysfunction” after HPV vaccination. All girls complained of long-lasting and invalidating somatoform symptoms (including asthenia, headache, cognitive dysfunctions, myalgia, sinus tachycardia and skin rashes) that have developed 1–5 days (n = 11), 5–15 days (n = 5) and 15–20 days (n = 2) after the vaccination. These cases can be included in the recently described immune dysfunction named autoimmune/inflammatory syndrome induced by adjuvants (ASIA). HPV vaccine, through its adjuvant component, is speculated to induce an abnormal activation of the immune system, involving glia cells in the nervous system too. Further researches should aim at defining the pathological and clinical aspects of these post-vaccination diseases and identifying a genetic background predisposing to these adverse reactions.

show abstract

Section: Discussionmentioning

confidence: 99%

Severe somatoform and dysautonomic syndromes after HPV vaccination: case series and review of literature

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Clinical evidence that POTS may have an autoimmune etiology has been mounting whereas POTS and other autonomic disorders have been observed in patients with multiple sclerosis, myasthenia gravis, Sjo¨gren's syndrome, SLE, RA and APS. [16][17][18][19] POTS can commonly occur after a viral illness 1 or after vaccination, 20 providing further evidence that an autoimmune and/or immunemediated process may underlie the etiology of POTS. However, the prevalence of autonomic disorders in patients with autoimmune conditions or the prevalence of autoimmune disorders in patients with POTS patients has not been determined.…”

Section: Resultsmentioning

confidence: 97%

Autoimmune markers and autoimmune disorders in patients with postural tachycardia syndrome (POTS)

Blitshteyn

2015

Lupus

View full text Add to dashboard Cite

show abstract

“…All subjects were diagnosed with orthostatic intolerance [7]. In the US, Blitshteyn reported a case series whose symptoms included dizziness, fatigue, nausea, weight loss and exercise intolerance [17], while in Mexico, Martinez-Lavín described two patients with fibromyalgia-type symptoms, including severe pain, insomnia, profound fatigue, and paraesthesia [18]. A signal of gastrointestinal motility disorders from the UMC described a case series of 26 subjects, in whom 15 reported concomitant fatigue, 13 reported either headache or migraine, and 9 reported dizziness [19].…”

Section: Discussionmentioning

confidence: 99%

Current Safety Concerns with Human Papillomavirus Vaccine: A Cluster Analysis of Reports in VigiBase®

et al. 2016

View full text Add to dashboard Cite

IntroductionA number of safety signals—complex regional pain syndrome (CRPS), postural orthostatic tachycardia syndrome (POTS), and chronic fatigue syndrome (CFS)—have emerged with human papillomavirus (HPV) vaccines, which share a similar pattern of symptomatology. Previous signal evaluations and epidemiological studies have largely relied on traditional methodologies and signals have been considered individually.ObjectiveThe aim of this study was to explore global reporting patterns for HPV vaccine for subgroups of reports with similar adverse event (AE) profiles.MethodsAll individual case safety reports (reports) for HPV vaccines in VigiBase® until 1 January 2015 were identified. A statistical cluster analysis algorithm was used to identify natural groupings based on AE profiles in a data-driven exploratory analysis. Clinical assessment of the clusters was performed to identify clusters relevant to current safety concerns.ResultsOverall, 54 clusters containing at least five reports were identified. The four largest clusters included 71 % of the analysed HPV reports and described AEs included in the product label. Four smaller clusters were identified to include case reports relevant to ongoing safety concerns (total of 694 cases). In all four of these clusters, the most commonly reported AE terms were headache and dizziness and fatigue or syncope; three of these four AE terms were reported in >50 % of the reports included in the clusters. These clusters had a higher proportion of serious cases compared with HPV reports overall (44–89 % in the clusters compared with 24 %). Furthermore, only a minority of reports included in these clusters included AE terms of diagnoses to explain these symptoms. Using proportional reporting ratios, the combination of headache and dizziness with either fatigue or syncope was found to be more commonly reported in HPV vaccine reports compared with non-HPV vaccine reports for females aged 9–25 years. This disproportionality remained when results were stratified by age and when those countries reporting the signals of CRPS (Japan) and POTS (Denmark) were excluded.ConclusionsCluster analysis reveals additional reports of AEs following HPV vaccination that are serious in nature and describe symptoms that overlap those reported in cases from the recent safety signals (POTS, CRPS, and CFS), but which do not report explicit diagnoses. While the causal association between HPV vaccination and these AEs remains uncertain, more extensive analyses of spontaneous reports can better identify the relevant case series for thorough signal evaluation.Electronic supplementary materialThe online version of this article (doi:10.1007/s40264-016-0456-3) contains supplementary material, which is available to authorized users.

show abstract

Postural tachycardia syndrome following human papillomavirus vaccination

Abstract: Correct diagnosis of POTS and awareness that POTS may occur after vaccination in young women is essential for prompt and effective management of this condition.

Cited by 82 publications

References 13 publications

Severe somatoform and dysautonomic syndromes after HPV vaccination: case series and review of literature

Severe somatoform and dysautonomic syndromes after HPV vaccination: case series and review of literature

Autoimmune markers and autoimmune disorders in patients with postural tachycardia syndrome (POTS)

Current Safety Concerns with Human Papillomavirus Vaccine: A Cluster Analysis of Reports in VigiBase®

Contact Info

Product

Resources

About