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Case report: A pediatric case of Bickerstaff brainstem encephalitis after COVID-19 vaccination and Mycoplasma pneumoniae infection: Looking for the culprit.
Monte, Gabriele; Pro, Stefano; Ursitti, Fabiana; Ferilli, Michela Ada Noris; Moavero, Romina; Papetti, Laura; Sforza, Giorgia; Bracaglia, Giorgia; Vigevano, Federico; Palma, Paolo; Valeriani, Massimiliano.
  • Monte G; Neurology Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
  • Pro S; Neurology Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
  • Ursitti F; Neurology Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
  • Ferilli MAN; Neurology Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
  • Moavero R; Neurology Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
  • Papetti L; Child Neurology and Psychiatry Unit, Department of System Medicine, Tor Vergata University of Rome, Rome, Italy.
  • Sforza G; Neurology Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
  • Bracaglia G; Neurology Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
  • Vigevano F; Department of Diagnostics and Laboratory Medicine, Medical Laboratory Unit, Unit of Allergy and Autoimmunity, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
  • Palma P; Neurology Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
  • Valeriani M; Academic Department of Pediatrics (DPUO), Research Unit of Clinical Immunology and Vaccinology, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
Front Immunol ; 13: 987968, 2022.
Article in English | MEDLINE | ID: covidwho-2005874
ABSTRACT
Bickerstaff brainstem encephalitis (BBE) is a rare, immune-mediated disease characterized by the acute onset of external ophthalmoplegia, ataxia, and consciousness disturbance. It has a complex multifactorial etiology, and a preceding infectious illness is seen in the majority of cases. Immune-mediated neurological syndromes following COVID-19 vaccination have been increasingly described. Here we report the case of a child developing BBE 2 weeks after COVID-19 vaccination. Despite nerve conduction studies and CSF analysis showing normal results, BBE was diagnosed on clinical ground and immunotherapy was started early with a complete recovery. Later, diagnosis was confirmed by positive anti-GQ1b IgG in serum. Even if there was a close temporal relationship between disease onset and COVID-19 vaccination, our patient also had evidence of a recent Mycoplasma pneumoniae infection that is associated with BBE. Indeed, the similarity between bacterial glycolipids and human myelin glycolipids, including gangliosides, could lead to an aberrantly immune activation against self-antigens (i.e., molecular mimicry). We considered the recent Mycoplasma pneumoniae infection a more plausible explanation of the disease onset. Our case report suggests that suspect cases of side effects related to COVID-19 vaccines need a careful evaluation in order to rule out well-known associated factors before claiming for a causal relationship.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Mycoplasma / Autoimmune Diseases of the Nervous System / Encephalitis / COVID-19 Type of study: Case report / Etiology study / Experimental Studies / Prognostic study Topics: Vaccines Limits: Child / Humans Language: English Journal: Front Immunol Year: 2022 Document Type: Article Affiliation country: Fimmu.2022.987968

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Mycoplasma / Autoimmune Diseases of the Nervous System / Encephalitis / COVID-19 Type of study: Case report / Etiology study / Experimental Studies / Prognostic study Topics: Vaccines Limits: Child / Humans Language: English Journal: Front Immunol Year: 2022 Document Type: Article Affiliation country: Fimmu.2022.987968