Transverse myelitis and vaccines: a multi-analysis

Abstract

Transverse myelitis is a rare clinical syndrome in which an immune-mediated process causes neural injury to the spinal cord. The pathogenesis of transverse myelitis is mostly of an autoimmune nature, triggered by various environmental factors, including vaccination. Our aim here was to search for and analyze reported cases of transverse myelitis following vaccination. A systematic review of PubMed, EMBASE and DynaMed for all English-language journals published between 1970 and 2009 was preformed, utilizing the key words transverse myelitis, myelitis, vaccines, post-vaccination, vaccination and autoimmunity. We have disclosed 37 reported cases of transverse myelitis associated with different vaccines including those against hepatitis B virus, measles-mumps-rubella, diphtheria-tetanus-pertussis and others, given to infants, children and adults. In most of these reported cases the temporal association was between several days and 3 months, although a longer time frame of up to several years was also suggested. Although vaccines harbor a major contribution to public health in the modern era, in rare cases they may be associated with autoimmune phenomena such as transverse myelitis. The associations of different vaccines with a single autoimmune phenomenon allude to the idea that a common denominator of these vaccines, such as an adjuvant, might trigger this syndrome.

Hepatitis-B Associated Acute Transverse Myelitis Mimicking Syringomyelia

“…In a review of vaccine related acute transverse myelitis [1], hepatitis B vaccine was found to be the most common vaccine associated with LETM. Several others like Oral Polio vaccine (OPV), diphtheriatetanus-pertussis (DTP) and influenza vaccines have also been reported to cause this adverse event [1].…”

“…Acute transverse myelitis (ATM) is a relatively uncommon neurological disorder characterized by inflammation of the spinal cord [1]. The inflammatory process often extends longitudinally over three or more segments and functionally transects the entire substance of the cord.…”

“…The inflammatory process often extends longitudinally over three or more segments and functionally transects the entire substance of the cord. This condition has diverse etiologies and has a well-known association with vaccinations especially hepatitis B vaccine [1]. Besides, several bacterial and viral infections are potential triggers for acute transverse myelitis.…”

Difteri Tetanoz Toksoid aşısından (Td) sonra gelişen transvers myelit: Olgu sunumu

“…Up to 50% of patients with TM have a preceding infection. It is reasonable to assume that as infectious agents can induce autoimmunity, so can the recombinant or live attenuated antigens or toxins used for vaccination (3). In addition to the infectious antigen, adjuvants which vaccines contain such as aluminum salt may be responsible for the autoimmunity and neurological deficits (3,29).…”

“…The mechanism of action of the vaccines is to stimulate the immune system. However this process carries the risk of developing rare neurological adverse reactions associated with vaccination (1)(2)(3)(4).…”