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VAERS Report 2157187

Case Report Section

Vaer Report Details

Age: 1 years old

Gender: Female

State: Outside US

Patient Died?
No
Vaccine information

Name: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)

Type: Measles, mumps and rubella virus vaccine, live

Manufacturer: UNKNOWN

Lot: unknown


Date report was received
2022-03-04
Date form completed
Date Vaccinated
Date of Onset
0
Number of days (onset date – vaccination date)
0
Adverse Event Description

adem, mogad and nmosd triggered by vaccination; adem, mogad and nmosd triggered by vaccination; adem, mogad and nmosd triggered by vaccination; information has been downloaded from regulatory agency (it-glaxosmithkline-it2022gsk026938). this literature marketed report was received from an author of the literature article entitled as stated above, referring to a 19 months-old female patient. a previously healthy 13-month-old girl was admitted to our hospital due to hyporeactivity and asymmetric tetraparesis with dystonic posturing, a week after an upper respiratory infection. brain magnetic resonance imaging (mri) showed symmetric talamic lesions, with involvement of the surrounding white matter and the right optic tract, cerebrospinal fluid (csf) studies including polymerase chain reaction (pcr) for hsv1 -2, vzv, cmv and anti-mog antibodies were normal. she was diagnosed with acute disseminated encephalomyelitis (adem) and treated with high dose intravenous methylprednisolone and 2 g/kg ivig. due to the age at onset and the basal ganglia involement, a biotin-thiamine-responsive basal ganglia disease was excluded by sequencing of the slc19a3 gene. further metabolic investigations including mitochondrial dna analysis wer� also negative. three months later her neurologic exam was unremarkable with the exception of mild right lower limb dystonia; her brain mri showed an almost complete resolution of previous abnormalities. on an unknown date, the patient was vaccinated with measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live (manufacturer unknown) (strength, formulation, dose, frequency, route, anatomical location, indication, lot# and expiration date were not reported). at 19 months of age, 17 days after the anti-measles, mumps, and rubella vaccine, the patient presented with acute onset of strabismus, vertical nystagmus and ataxia. brain and spinal cord mri showed new lesions in the supra- and infratentorial white matter and in the optic nerves, and a longitudinally-extensive transverse myelitis (ltem) lesion dl c2-c4 level. as in the first episode, inflammatory markers were negative. csf studies were normal, with oligoclonal bands, anti-aquaporin and anti-mog antibodies negative both on serum and csf. complement function was normal and blood ifn sig- nature was negative. a transient positivity for ana (1:640) and for p-anca was observed but not confirmed in further testing. hla-b51 was detected. whole exome sequencing (wes) was not contributive, despite a reanalysis of greater than 250 neuroinflammation related genes. she again required high dose intravenous methylprednisolone and was started on periodic 2 g/kg intravenous immunoglobulin (ivig) for 12 months. despite almost complete regression of neuro- logic signs, mri lesions improved but persisted. nine months after the last neurological event, the patient developed arthritis involving the temporomandibular joint, the right knee and ankle, requiring treatment with intra-articular steroid injections. based on the joint involvement and the positivity of hla- b51, she was also started on methotrexate and colchicine. at the age of 38 months, she was neurologically stable with fluctuant right lower limb dystonia, despite incomplete regression of right ankle arthritis. on an unknown date, the patient experienced recurrent neuroinflammation presenting with features of adem, myelin oligodendrocyte glycoprotein antibody-associated disease (mogad) and neuromyelitis optica spectrum disorder (nmosd), triggered by vaccination associated with arthritis which resulted in hospitalization. the outcome of the events was not reported. upon internal review, the events acute disseminated encephalomyelitis (adem), myelin oligodendrocyte glycoprotein antibody-associated disease (mogad) and neuromyelitis optica spectrum disorder (nmosd) were considered as medically significant. the relatedness between the events and suspect vaccines was considered as related. a copy of the published article is attached as further documentation of the patient's experience

Lab Data
test name: anti-aquaporin; test result: negative ; test name: anti-mog antibodies; test result: negative ; test name: blood interferon (ifn) signature; test result: negative ; test name: p-antineutrophil cytoplasmic antibodies; test result: positive ; test name: antinuclear antibody; test result: positive ; test name: oligoclonal band; test result: negative ; test name: inflammatory markers; test result: negative ; test name: metabolic investigations; test result: negative
List of symptoms
neuromyelitis optica spectrum disorder immunoglobulin therapy hla marker study positive arthritis nystagmus condition aggravated strabismus dystonia laboratory test normal vaccination complication metabolic function test normal antinuclear antibody positive myelitis transverse neurological symptom antibody test negative acute disseminated encephalomyelitis csf test normal ataxia central nervous system inflammation complement factor normal csf oligoclonal band absent intervertebral disc disorder antineutrophil cytoplasmic antibody positive magnetic resonance imaging spinal abnormal gene sequencing white matter lesion magnetic resonance imaging head abnormal inflammatory marker test anti-aquaporin-4 antibody negative myelin oligodendrocyte glycoprotein antibody-associated disease
Patient Died?
No
Date Died
NA
Birth defect
false
Vaccine Administered By:
Unknown
Vaccine Purchased By:
Unknown
Patient visit ER?
No
Patient Hospitalized?
Yes
Stay in hospital
No
Days in hospital
Unspecified
Permanent disability?
No
Allergies:
na
Current Illness
acute disseminated encephalomyelitis