Cases of narcolepsy-cataplexy syndrome following H1N1 vaccination/H1N1 (domuz gribi) asisini takiben ortaya cikan narkolepsi-katapleksi sendromu olgulari

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Authors: Mecbure Nalbantoglu, Gulcin Benbir, Derya Karadeniz, Ayse Altintas and Fatma Savran Oguz
Date: Sept. 2014
From: Archives of Neuropsychiatry(Vol. 51, Issue 3)
Publisher: AVES
Document Type: Case study
Length: 2,594 words

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Abstract :

Narcolepsy-Cataplexy syndrome is a rare sleep disorder related with human leukocyte antigens (HLA-DQB1*0602) caused by the loss of hypothalamic hypocretin/orexin producing neurons. Recently, in European countries, Narcolepsy-Cataplexy syndrome developing following H1N1 vaccination has attracted attention. Our first patient was a 9-year-old boy, who was referred to our clinic with the complaint of daytime sleepiness developed 1.5 month after H1N1 vaccination. After a couple of weeks, weakness of the upper extremities while laughing was added to the clinical picture. He also developed hypnopompic hallucinations and nightmares. Multiple sleep latency test (MSLT) following full-night polysomnography (PSG) showed that the mean sleep latency was 0.6 minutes; and all of the naps had sleep-onset REM periods. Our second patient was a 50 year-old-man, who presented to our clinic complaining of sleep paralysis and REM sleep behavior disorder developed 4 months after H1N1 vaccination. He developed daytime sleepiness 6 months after and cataplexy 8 months after H1N1 vaccination. He was also diagnosed as having Narcolepsy-Cataplexy syndrome upon PSG and MSLT. We investigated HLA-DRB1/ DQB1 locus with Polymerase Chain Reaction-Sequence Specific Primer technique. The first patient had HLA-DQB1*0602.47 and DQB1*03.01 heterozygous loci; and the second patient had HLA-DQB1*0602.47 and DQB1*02.01 heterozygous loci. These patients are the first reported cases of Narcolepsy-Cataplexy syndrome related with H1N1 vaccination in Turkey. Although there is no specific marker, temporal relationship between vaccination and onset of disease symptoms suggests a possible causal relationship. In the presence of an underlying genetic predisposition, it was thought that H1N1 vaccination could trigger Narcolepsy-Cataplexy syndrome. (Archives of Neuropsychiatry 2014; 51:283-287) Key words: H1N1 vaccination, swine flu, narcolepsy, cataplexy Narkolepsi-Katapleksi sendromu, insan lokosit antijenleri (HLA-DQB1/0602) ile iliskili, uyanikliktan sorumlu hipokretin peptit eksikligine bagli gelisen nadir bir uyku hastaligidir. H1N1 domuz gribi asisi sonrasinda Avrupa ulkelerinde narkolepsi-katapleksi endemisinin ortaya cikmasi dikkatleri cekmistir. Turkiye'de H1N1 asisina bagli ortaya cikan Narkolepsi-Katapleksi sendromu olgusu henuz bildirilmemistir. Ilk olgumuz, 9 yasinda erkek hasta domuz gribi asisini takiben 1,5 ay icinde ortaya cikan gun ici asiri uykululuk hali, gulerken ust ekstremitelerde gucsuzluk, hipnopompik halusinasyonlar ve kabuslar nedeniyle basvurdu. Ikinci olgumuz 50 yasinda erkek hastada, domuz gribi asisindan 4 ay sonra uyku paralizisi ve REM uykusu davranis bozuklugu, 6 ay sonra gunduz asiri uykululuk hali, 8 ay sonra gulunce/aglayinca ortaya cikan dusme/hareket edememe sikayetlerinin ortaya cikmasi uzerine basvurdu. Hastalarimiza, Polisomnografinin (PSG) ardindan Coklu Uyku Latans Testi (CULT) yapilarak Narkolepsi-Katapleksi sendromu tanisi konuldu. Her iki hastamiza yuksek cozunurluklu PCR-SSP (Polymerase Chain Reaction-Sequence Specific Primer) teknigi ile HLA-DRB1/DQB1 lokus incelemesi yapildi. Ilk olguda HLA-DQB1/0602.47 ve DQB1/03.01 heterozigot lokus; ikinci hastamizda HLA-DQB1/0602.47 ve DQB1/02.01 heterozigot lokus saptandi. Sundugumuz iki olgu, Turkiye'de H1N1 asisiyla iliskili olarak bildirilen ilk olgulardir. Ozgun gostergelerin olmamasina karsin, asi ve hastalik sikayetleri arasindaki zamansal iliski, olasi neden-sonuc iliskisini akla getirmekte; altta yatan genetik yatkinlik varliginda H1N1 asisinin Narkolepsi-Katapleksi sendromunu tetikleyebilecegi dusunulmektedir. (Noropsikiyatri Arsivi 2014; 51:283-287) Anahtar kelimeler: H1N1 asisi, domuz gribi, narkolepsi, katapleksi

Source Citation

Source Citation
Nalbantoglu, Mecbure, et al. "Cases of narcolepsy-cataplexy syndrome following H1N1 vaccination/H1N1 (domuz gribi) asisini takiben ortaya cikan narkolepsi-katapleksi sendromu olgulari." Archives of Neuropsychiatry, vol. 51, no. 3, 2014, p. 283+. Accessed 10 Apr. 2021.
  

Gale Document Number: GALE|A402877350