title: Severe somatoform and dysautonomic syndromes after HPV vaccination: case series and review of literature.
abstract: Human papilloma virus (HPV) is recognized as a major cause for cervical cancer among women worldwide. Two HPV vaccines are currently available: Gardasil®and Cervarix®. Both vaccines enclose viral antigenic proteins, but differ as to the biological systems of culture and the adjuvant components. Recently, a collection of symptoms, indicating nervous system dysfunction, has been described after HPV vaccination. We retrospectively described a case series including 18 girls (aged 12-24 years) referred to our "Second Opinion Medical Network" for the evaluation of "neuropathy with autonomic dysfunction" after HPV vaccination. All girls complained of long-lasting and invalidating somatoform symptoms (including asthenia, headache, cognitive dysfunctions, myalgia, sinus tachycardia and skin rashes) that have developed 1-5 days (n = 11), 5-15 days (n = 5) and 15-20 days (n = 2) after the vaccination. These cases can be included in the recently described immune dysfunction named autoimmune/inflammatory syndrome induced by adjuvants (ASIA). HPV vaccine, through its adjuvant component, is speculated to induce an abnormal activation of the immune system, involving glia cells in the nervous system too. Further researches should aim at defining the pathological and clinical aspects of these post-vaccination diseases and identifying a genetic background predisposing to these adverse reactions.
authors: Department of General Surgery and Surgical Specialties, University of Modena and Reggio Emilia Medical School, Surgical Clinic, Modena, Italy. palmieri@unimore.it.
authors: Beniamino
authors: B
authors: Palmieri
authors: Department of Paediatrics, ASST Melegnano e Martesana, Vizzolo Predabissi, MI, Italy. dimimedpv@yahoo.it.
authors: Dimitri
authors: D
authors: Poddighe
authors: Department of General Surgery and Surgical Specialties, University of Modena and Reggio Emilia Medical School, Surgical Clinic, Modena, Italy.
authors: Maria
authors: M
authors: Vadalà
authors: Department of General Surgery and Surgical Specialties, University of Modena and Reggio Emilia Medical School, Surgical Clinic, Modena, Italy.
authors: Carmen
authors: C
authors: Laurino
authors: Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, National Research Council-Institute of Neuroscience, University Hospital L. Sacco, University of Milano, Milan, Italy.
authors: Carla
authors: C
authors: Carnovale
authors: Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences, National Research Council-Institute of Neuroscience, University Hospital L. Sacco, University of Milano, Milan, Italy.
authors: Emilio
authors: E
authors: Clementi
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D053918:Papillomavirus Vaccines / Q000009:adverse effects*; D013577:Syndrome; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: ADR; ASIA; Adjuvant; Autoimmune syndrome; HPV; Symptoms; Vaccine