Sex: F
Vaccine: TDAP
Symptoms: CSF white blood cell count increased, Cauda equina syndrome, Hypoaesthesia, Immunoglobulin therapy, Nuclear magnetic resonance imaging
Clinical narrative: This case was reported in a literature article and described the occurrence of acute disseminated encephalomyelitis in a 55-year-old female patient who received DTPa vaccine. On an unknown date, the patient received DTPa vaccine at an unknown dose. On an unknown date, less than a month after receiving DTPa vaccine, the patient experienced acute disseminated encephalomyelitis (serious criteria GSK medically significant), cauda equina syndrome (serious criteria GSK medically significant), anesthesia, fecal incontinence, urinary incontinence, numbness of lower extremities, white matter hyperintensities and pleocytosis. The patient was treated with Intravenous Immunoglobulin. On an unknown date, the outcome of the acute disseminated encephalomyelitis, cauda equina syndrome, anesthesia, fecal incontinence, urinary incontinence, numbness of lower extremities, white matter hyperintensities and pleocytosis were unknown. The reporter considered the acute disseminated encephalomyelitis, cauda equina syndrome, anesthesia, fecal incontinence, urinary incontinence, numbness of lower extremities, white matter hyperintensities and pleocytosis to be possibly related to DTPa vaccine. Additional information was provided. This case was reported in a literature article and described the occurrence of acute disseminated encephalomyelitis in a 55-year-old female patient who was vaccinated with unspecified TDaP vaccine (manufacturer unknown). No information on patient's medical or family history or concurrent condition or concomitant medication was provided. On an unspecified date, the patient received unspecified TDaP vaccine (administration route and site unspecified; dosages unknown; batch number not provided). The age of vaccination was not provided. On an unspecified date between, 2 weeks after vaccination, the patient presented to the hospital with progressive symptoms of cauda equina syndrome, with saddle anesthesia, urinary and fecal incontinence, and lower extremity numbness. Magnetic resonance imaging (MRI) of the neuro-axis was notable for T2/FLAIR hyperintense signal of the distal cord/conus with corresponding enhancement, and enhancement of the cauda equina. The patient was treated with intravenous immunoglobulin (IVIg) and transferred to Hospital between July and October 2016, where, cerebrospinal fluid, clear (CSF) studies showed a lymphocytic pleocytosis with 14 white blood cells (WBCs) (normal range not provided) and normal protein (value and normal range not provided). Extensive workup was unrevealing. Subsequently, the patient was diagnosed with acute disseminated encephalomyelitis. The outcome of the event was not reported. The authors considered the event of acute disseminated encephalomyelitis possibly associated to unspecified TDaP vaccine. The author concluded, "This two patient case series provides further evidence for a possible association between TDaP vaccination and acute demyelinating events". This is 1 of 2 valid  cases [Due to memory limitations, the remainder of this text could not be compared.] in the same literature article.