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Anti-NMDA receptor encephalitis and vaccination: A disproportionality analysis

Anti–N-methyl-D-aspartate receptor (NMDAR) encephalitis is an auto-immune neurological disorder characterized by the presence in the cerebrospinal fluid (CSF) of antibodies against the GluN1 subunit of NMDA receptors in the brain. The etiology of the disease remains largely unknown. In this study, w...

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Autores principales: Martin, Salomé, Azzouz, Brahim, Morel, Aurore, Trenque, Thierry
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9428621/
https://www.ncbi.nlm.nih.gov/pubmed/36059934
http://dx.doi.org/10.3389/fphar.2022.940780
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author Martin, Salomé
Azzouz, Brahim
Morel, Aurore
Trenque, Thierry
author_facet Martin, Salomé
Azzouz, Brahim
Morel, Aurore
Trenque, Thierry
author_sort Martin, Salomé
collection PubMed
description Anti–N-methyl-D-aspartate receptor (NMDAR) encephalitis is an auto-immune neurological disorder characterized by the presence in the cerebrospinal fluid (CSF) of antibodies against the GluN1 subunit of NMDA receptors in the brain. The etiology of the disease remains largely unknown. In this study, we aimed to investigate the possible existence of pharmacovigilance signals relating to a link between vaccination and the occurrence of anti-NMDAR encephalitis. We performed a case/non-case study using data from the World Health Organization pharmacovigilance database (VigiBase) up to 31 December 2021. All individual case study reports (ICSRs) linked to a vaccine and coded with the MedDRA Lower Level Term (LLT) “anti-NMDA receptor encephalitis” were analysed. We calculated the Reporting Odds Ratio (ROR) and 95% Confidence Interval (CI) for each type of vaccine. A total of 29,758,737 ICSRs were registered in VigiBase, of which 70 were coded under the selected LLT, and 29/70 (41.4%) involved a vaccine. Of these cases, 53.8% involved children aged younger than 15 years. The median time to onset of anti-NMDAR encephalitis after vaccination was 4 days (range 0–730). The highest RORs were observed for the diphtheria/polio/tetanus/pertussis vaccine [54.72 (95% CI 26.2–114.3)], yellow fever vaccine [50.02 (95% CI 15.7–159)] and human papillomavirus vaccine [32.89 (15.8–68.7)]. All cases were coded as serious; 13 patients did not recover, or were left with permanent sequelae. Nine patients recovered without sequelae or are on the path to recovery, and one patient died. In summary, pharmacovigilance signals were observed for anti-NMDAR encephalitis and vaccination. Clinicians need to be aware of this potential risk, and encourage to report any case of anti-NMDAR encephalitis occurring after vaccination.
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spelling pubmed-94286212022-09-01 Anti-NMDA receptor encephalitis and vaccination: A disproportionality analysis Martin, Salomé Azzouz, Brahim Morel, Aurore Trenque, Thierry Front Pharmacol Pharmacology Anti–N-methyl-D-aspartate receptor (NMDAR) encephalitis is an auto-immune neurological disorder characterized by the presence in the cerebrospinal fluid (CSF) of antibodies against the GluN1 subunit of NMDA receptors in the brain. The etiology of the disease remains largely unknown. In this study, we aimed to investigate the possible existence of pharmacovigilance signals relating to a link between vaccination and the occurrence of anti-NMDAR encephalitis. We performed a case/non-case study using data from the World Health Organization pharmacovigilance database (VigiBase) up to 31 December 2021. All individual case study reports (ICSRs) linked to a vaccine and coded with the MedDRA Lower Level Term (LLT) “anti-NMDA receptor encephalitis” were analysed. We calculated the Reporting Odds Ratio (ROR) and 95% Confidence Interval (CI) for each type of vaccine. A total of 29,758,737 ICSRs were registered in VigiBase, of which 70 were coded under the selected LLT, and 29/70 (41.4%) involved a vaccine. Of these cases, 53.8% involved children aged younger than 15 years. The median time to onset of anti-NMDAR encephalitis after vaccination was 4 days (range 0–730). The highest RORs were observed for the diphtheria/polio/tetanus/pertussis vaccine [54.72 (95% CI 26.2–114.3)], yellow fever vaccine [50.02 (95% CI 15.7–159)] and human papillomavirus vaccine [32.89 (15.8–68.7)]. All cases were coded as serious; 13 patients did not recover, or were left with permanent sequelae. Nine patients recovered without sequelae or are on the path to recovery, and one patient died. In summary, pharmacovigilance signals were observed for anti-NMDAR encephalitis and vaccination. Clinicians need to be aware of this potential risk, and encourage to report any case of anti-NMDAR encephalitis occurring after vaccination. Frontiers Media S.A. 2022-08-17 /pmc/articles/PMC9428621/ /pubmed/36059934 http://dx.doi.org/10.3389/fphar.2022.940780 Text en Copyright © 2022 Martin, Azzouz, Morel and Trenque. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Martin, Salomé
Azzouz, Brahim
Morel, Aurore
Trenque, Thierry
Anti-NMDA receptor encephalitis and vaccination: A disproportionality analysis
title Anti-NMDA receptor encephalitis and vaccination: A disproportionality analysis
title_full Anti-NMDA receptor encephalitis and vaccination: A disproportionality analysis
title_fullStr Anti-NMDA receptor encephalitis and vaccination: A disproportionality analysis
title_full_unstemmed Anti-NMDA receptor encephalitis and vaccination: A disproportionality analysis
title_short Anti-NMDA receptor encephalitis and vaccination: A disproportionality analysis
title_sort anti-nmda receptor encephalitis and vaccination: a disproportionality analysis
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9428621/
https://www.ncbi.nlm.nih.gov/pubmed/36059934
http://dx.doi.org/10.3389/fphar.2022.940780
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