title: A patient with both narcolepsy and multiple sclerosis in association with Pandemrix vaccination.
abstract: Narcolepsy with cataplexy is caused by a selective loss of hypocretin-producing neurons, but symptomatic narcolepsy can also result from hypothalamic and brainstem lesions caused by multiple sclerosis (MS). We report a previously healthy man who developed clinical and laboratory verified narcolepsy without having any indication of hypothalamic lesions and MS after vaccination against the influenza H1N1 with Pandemrix. HLA typing showed both DRB1*15:01, associated with MS and DQB1*06:02, associated with narcolepsy. The genetic susceptibility in this patient makes it tempting to speculate upon an immune-mediated mechanism and a common etiology for both diseases in this patient.
authors: Division of Neurology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Department of Neurology and Neurophysiology, County Council of Östergötland, Linköping, Sweden. magnus.vrethem@lio.se
authors: Magnus
authors: M
authors: Vrethem
authors: Kristina
authors: K
authors: Malmgren
authors: Jonas
authors: J
authors: Lindh
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D034961:Antigens, Nuclear / Q000378:metabolism; D051401:Aquaporin 4 / Q000378:metabolism; D006801:Humans; D007252:Influenza Vaccines / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000139:chemically induced* / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D009290:Narcolepsy / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D013116:Spinal Cord / Q000473:pathology
chemical_list: C496030:AQP4 protein, human; D000893:Anti-Inflammatory Agents; D034961:Antigens, Nuclear; D051401:Aquaporin 4; D007252:Influenza Vaccines; C556153:pandemrix; D008775:Methylprednisolone