What question did this study set out to answer?

To describe the clinical, biochemical, and genetic characteristics of an abrupt surge in recent-onset narcolepsy-cataplexy following H1N1 influenza vaccination or natural infection.

November 1, 2010SLEEPOpen Access

Post-H1N1 Narcolepsy-Cataplexy

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Authors

YDYves DauvilliersUniversité Paris-Sud JMJacques MontplaisirUniversity of Copenhagen VCValérie CochenHôpital Gui de Chauliac

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Implication

Case series reveals abrupt onset of severe narcolepsy in H1N1-vaccinated and infected individuals, suggesting an immune trigger in genetically susceptible hosts.

Key Points

To describe the clinical, biochemical, and genetic characteristics of an abrupt surge in recent-onset narcolepsy-cataplexy following H1N1 influenza vaccination or natural infection.
Retrospective multicenter case series at three narcolepsy reference centers (Montpellier, France; Montreal, Canada; Stanford, United States) assessing recent-onset cases from September 2009 to August 2010 (N=31).
Patients underwent chart reviews, clinical interviews, Multiple Sleep Latency Tests (MSLT), HLA DQB1*0602 typing, and cerebrospinal fluid (CSF) hypocretin-1 measurements.
Serum specimens were assayed for antistreptolysin O (ASO) and anti-TRIB2 autoantibodies.
Identified 16 post-H1N1 cases (14 post-vaccination, including 11 with AS03 adjuvant, and 2 post-infection); all 16 patients (100%) were HLA DQB1*0602 positive with severe daytime sleepiness and cataplexy.
All 10 evaluated patients had deficient CSF hypocretin-1 (< 110 pg/mL), 11 of 11 tested had confirmatory MSLT results, and 11 of 16 (68.7%) had elevated ASO titers, while none had anti-TRIB2 antibodies.
Cataplexy onset occurred 2 to 8 weeks post-vaccination in 9 of 14 cases, presenting with rapid onset, atypical ages (< 5 years in 2 cases, > 38 years in 5 cases), and frequent rapid weight gain.

Cite This Study

Dauvilliers et al. (2010) studied this question.

synapsesocial.com/papers/6a797e684353fbf0600208bd https://doi.org/10.1093/sleep/33.11.1428

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Implication

Case series reveals abrupt onset of severe narcolepsy in H1N1-vaccinated and infected individuals, suggesting an immune trigger in genetically susceptible hosts.

Post-H1N1 Narcolepsy-Cataplexy

Discussion

Member takes

Implication

Key Points

Cite This Study

Post-H1N1 Narcolepsy-Cataplexy

Discussion

Member takes

Implication

Key Points

Cite This Study

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