Data_Sheet_1_Case report: Anti-GAD65 antibody-associated autoimmune encephalitis following HPV vaccination.docx

Human papillomavirus (HPV) infection is a sexually transmitted disease that may lead to cervical cancer. HPV vaccines have been implemented widely to prevent this. While generally few complications of vaccination are reported, there have been occasional reports of adverse reactions post-vaccination. The safety profile of the HPV vaccine is reassuring. However, since its introduction, several serious post-vaccination central nervous system complications have been reported; however, causality has not been established. Herein, we describe a 39-year-old woman who developed seizures and experienced a rapid decline in memory shortly after her first dose of the HPV vaccine. Cranial magnetic resonance imaging and cerebrospinal fluid analysis were performed, and the patient was diagnosed with anti-glutamic acid decarboxylase 65 (anti-GAD65) antibody-associated autoimmune encephalitis. She responded well to high-dose glucocorticoids. Four-month follow-up revealed full recovery and absence of recurrence. Since the HPV vaccine is administered worldwide, this case should raise clinicians' awareness regarding the possible CNS complications related to vaccinations, such as anti-GAD65 antibody-associated AE.

人乳头瘤病毒（Human papillomavirus, HPV）感染是一种性传播疾病，可诱发宫颈癌。目前HPV疫苗已被广泛用于预防该病。尽管疫苗接种相关并发症的报道总体较为少见，但仍偶有接种后不良反应的报告，HPV疫苗的整体安全性令人放心。不过，自该疫苗投入临床使用以来，已有数例严重的疫苗接种后中枢神经系统并发症被报道，但目前尚未明确其与疫苗接种的因果关联。
本文报告1例39岁女性患者：其在接种首剂HPV疫苗后不久出现癫痫发作，并迅速出现记忆力减退。完善颅脑磁共振成像与脑脊液分析后，患者被确诊为抗谷氨酸脱羧酶65（anti-glutamic acid decarboxylase 65, anti-GAD65）抗体相关自身免疫性脑炎。患者接受大剂量糖皮质激素治疗后反应良好。随访4个月后，患者完全康复且未见复发。
鉴于HPV疫苗在全球范围内广泛接种，本病例应提醒临床医师警惕疫苗接种可能引发的中枢神经系统并发症，如anti-GAD65抗体相关自身免疫性脑炎。