Bilateral optic neuropathy with loss of vision after an influenza vaccination in a patient suffering from mixed connective tissue disease

• Published in: Revue neurologique 2010-12, Vol.166 (12), p.1024-1027
• Main Authors: Laffon-Pioger, M, Rocher, F, Cohen, M, Chanalet, S, Thomas, P, Lebrun, C
• Format: Article
• Language: fre
• Subjects: Anti-Inflammatory Agents - therapeutic use; Atrophy; Female; Humans; Influenza Vaccines - adverse effects; Magnetic Resonance Imaging; Methylprednisolone - therapeutic use; Middle Aged; Mixed Connective Tissue Disease - complications; Optic Nerve - pathology; Optic Nerve Diseases - etiology; Optic Nerve Diseases - pathology
• ISSN: 0035-3787
• DOI: 10.1016/j.neurol.2010.07.037

Optic neuropathy is a rare adverse reaction to vaccination. A 62-year-old-woman was hospitalized for bilateral optic neuropathy with loss of vision. The symptoms occurred 15 days after a seasonal influenza vaccination. Her past medical history included a mixed connective tissue disease with no immunosuppressive treatment for several years. Investigations did not reveal any obvious cause and the hypothesis of post-influenza vaccination bilateral optic neuropathy was retained although a complication of the connective tissue disease complication could not be ruled out. The patient was given intravenous methylprednisolone 1g daily. At a cumulative dose of 8 g, oral steroids were given and tapered off. Few similar case reports have been described in literature. The causal link between vaccination and optic neuropathy thus remains to be confirmed. Clinicians should however consider this etiology.