Immune triggers preceding neuralgic amyotrophy

Background and purpose Infections and vaccinations have been identified as potential immunological triggers of neuralgic amyotrophy (NA), but the exact type and frequency of the preceding agents is unknown. Methods This was a multicentre, prospective, observational, matched case–control study. NA wa...

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Published in:European journal of neurology Vol. 31; no. 12; pp. e16462 - n/a
Main Authors: Sparasci, Davide, Schilg‐Hafer, Lenka, Schreiner, Bettina, Scheidegger, Olivier, Peyer, Anne‐Kathrin, Lascano, Agustina Maria, Vicino, Alex, Décard, Bernhard Friedrich, Tsouni, Pinelopi, Humm, Andrea Monika, Pianezzi, Enea, Zezza, Giulia, Hundsberger, Thomas, Dietmann, Anelia, Jung, Hans H., Kuntzer, Thierry, Wilder‐Smith, Einar, Martinetti‐Lucchini, Gladys, Petrini, Orlando, Fontana, Stefano, Gowland, Peter, Niederhauser, Christoph, Gobbi, Claudio, Ripellino, Paolo
Format: Journal Article
Language:English
Published: England John Wiley & Sons, Inc 01.12.2024
John Wiley and Sons Inc
Subjects:
Adult
Aged
Biological properties
Biological samples
Brachial Plexus Neuritis - etiology
Case-Control Studies
Coronaviruses
COVID-19
COVID-19 - complications
COVID-19 - immunology
COVID-19 Vaccines - immunology
Cytomegalovirus
Disease control
Epstein-Barr virus
Female
Hepatitis
HIV
Human immunodeficiency virus
Humans
immune trigger
Immunization
Immunology
infection
Infections
Male
Middle Aged
neuralgic amyotrophy
Neuromuscular system
Neuropathies
Original
Parsonage–Turner syndrome
Parvoviruses
Prospective Studies
Respiratory diseases
Serological tests
Severe acute respiratory syndrome
Severe acute respiratory syndrome coronavirus 2
Vaccination
Varicella
Viral diseases
Viral infections
infection
neuralgic amyotrophy
immune trigger
Parsonage–Turner syndrome
vaccination
ISSN:1351-5101, 1468-1331, 1468-1331
Online Access:Get full text
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Summary:Background and purpose Infections and vaccinations have been identified as potential immunological triggers of neuralgic amyotrophy (NA), but the exact type and frequency of the preceding agents is unknown. Methods This was a multicentre, prospective, observational, matched case–control study. NA was diagnosed by neuromuscular experts according to validated clinical criteria and electrodiagnostic studies. Clinical data and biological samples of NA patients were collected within 90 days from disease onset between June 2018 and December 2023. All NA patients were asked about prior infection and vaccination in the month before disease onset. Serological tests for hepatitis E virus, human immunodeficiency virus, severe acute respiratory syndrome coronavirus 2, Epstein–Barr virus, cytomegalovirus, parvovirus B19, varicella‐zoster virus, Borrelia burgdorferi, Mycoplasma pneumoniae and Bartonella henselae were performed in a central laboratory. Each case was matched with a healthy control for age, sex, place of residence and time of blood collection. Results Fifty‐seven patients and corresponding controls were included. The mean age was 45 years for both groups. NA onset was preceded by a symptomatic infectious trigger confirmed by microbiological tests in 15/57 (26.3%) patients. Coronavirus disease 2019 vaccination was considered a potential trigger in 7/57 (12.3%) subjects. An acute viral infection was associated with a bilateral involvement of the brachial plexus (p = 0.003, Cramèr's V = 0.43). Conclusions Confirmed immune triggers (infection or vaccination) preceded disease onset in 22/57 (38.6%) NA cases. We suggest to test NA patients in the acute phase for intracellular antigens, especially in the case of concomitant bilateral involvement and hepatitis.
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ISSN:1351-5101
1468-1331
1468-1331
DOI:10.1111/ene.16462