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Immune triggers preceding neuralgic amyotrophy

Authors: Sparasci, Davide; Schilg‐Hafer, Lenka; Schreiner, Bettina; Scheidegger, Olivier; Peyer, Anne‐Kathrin; Lascano, Agustina Maria; Vicino, Alex; +17 Authors

Immune triggers preceding neuralgic amyotrophy

Abstract

AbstractBackground and purposeInfections 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.MethodsThis 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.ResultsFifty‐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).ConclusionsConfirmed 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.

Keywords

Male, Adult, 616.8, COVID-19 Vaccines, 610 Medicine & health, Immune trigger, Humans; Brachial Plexus Neuritis/etiology; Female; Male; Middle Aged; Adult; Case-Control Studies; Prospective Studies; COVID-19/immunology; COVID-19/complications; COVID-19 Vaccines/immunology; Aged; Parsonage–Turner syndrome; immune trigger; infection; neuralgic amyotrophy; vaccination, neuralgic amyotrophy, Humans, Brachial Plexus Neuritis, Prospective Studies, Aged, Vaccination, immune trigger, COVID-19, Neuralgic amyotrophy, Middle Aged, vaccination, Neuropathies, Parsonage–Turner syndrome, infection, 10040 Clinic for Neurology, 2728 Neurology (clinical), 2808 Neurology, Case-Control Studies, Female, Infection

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
Average
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