An outbreak of neurological autoimmunity with polyradiculoneuropathy in workers exposed to aerosolised porcine neural tissue: a descriptive study

  title={An outbreak of neurological autoimmunity with polyradiculoneuropathy in workers exposed to aerosolised porcine neural tissue: a descriptive study},
  author={Daniel H. Lachance and Vanda A. Lennon and Sean J. Pittock and Jennifer A. Tracy and Karl N. Krecke and Kimberly K. Amrami and Eric M. Poeschla and Robert Michael Orenstein and Bernd W. Scheithauer and James Sejvar and Stacy M. Holzbauer and Aaron S DeVries and P. James B. Dyck},
  journal={The Lancet Neurology},
Epidemiologic Investigation of Immune-Mediated Polyradiculoneuropathy among Abattoir Workers Exposed to Porcine Brain
This novel polyradiculoneuropathy was associated with removing porcine brains with compressed air and an autoimmune mechanism is supported by higher levels of IFNγ in cases than in controls consistent with other immune mediated illnesses occurring in association with neural tissue exposure.
Auto‐immune polyradiculoneuropathy and a novel IgG biomarker in workers exposed to aerosolized porcine brain
  • J. Tracy, P. Dyck
  • Medicine, Biology
    Journal of the peripheral nervous system : JPNS
  • 2011
It is postulate that this outbreak is an auto‐immune polyradiculoneuropathy triggered by occupational exposure to multiple aerosolized porcine neural tissue antigens that result in neural damage where the blood‐nerve barrier is the least robust.
Delayed onset of severe chronic pain in CASPR2 autoantibody–associated Morvan syndrome in a former UK swine abattoir worker
The case of a 76-year-old, United Kingdom male diagnosed with contactin-associated protein 2 (CASPR2) autoantibody–associated Morvan syndrome, a rare neurological condition, highlights issues around the identification and treatment of rare patients with chronic pain who have voltage-gated potassium channel complexAutoantibodies and emphasizes the possibility that former swine abattoir workers might be at risk of developing neuropathic pain even years after their vocational exposure.
Immunotherapy-responsive pain in an abattoir worker with fluctuating potassium channel-complex IgG
An early presenting case from this outbreak who was followed longitudinally with pain-predominant symptomatology, a newly recognized manifestation of voltage-gated potassium channel (VGKC)-complex autoimmunity is described.
Archeological neuroimmunology: resurrection of a pathogenic immune response from a historical case sheds light on human autoimmune encephalomyelitis and multiple sclerosis
It is suggested that immunization with bovine brain tissue in humans may—in a small subset of patients—induce a disease with an intermediate clinical and pathological presentation between MS and MOG-antibody associated inflammatory demyelinating disease (MOGAD).
Autoimmune encephalitis in humans: how closely does it reflect multiple sclerosis ?
This study shows that auto-sensitization of humans with brain tissue can induce a disease, which closely reflects the pathology of MS, but that the mechanisms leading to demyelination and tissue injury differ from those, generally implicated in the pathophysiology of MS through studies in experimental autoimmune encephalomyelitis.
Neurologic autoimmunity: mechanisms revealed by animal models.
Neural antigen‐specific autoimmune disorders
The focus of this review is the immunobiology, pathophysiology, and clinical spectrum of autoimmune neurological disorders accompanied by neural‐specific IgGs, which are frequently misdiagnosed as neurodegenerative.
CNS inflammation and neurodegeneration: sequelae of peripheral inoculation with spinal cord tissue in rat.
The results of these experiments demonstrate that peripheral exposure to spinal cord antigens is associated with CNS-directed autoimmunity and inflammation in the brain and spinal cord as well as degeneration of CNS cells, memory impairment, and production of neurodegenerative proteins particularly when this exposure is repeated.


Glutamic acid decarboxylase autoimmunity with brainstem, extrapyramidal, and spinal cord dysfunction.
A patient with a presumed neurodegenerative disorder of new onset, with high levels of GAD65 antibody (>20 nmol/L), merits consideration of immunotherapy.
Neural Autoantibody Profile of Primary Achalasia
The serum profile of autoantibodies suggests an autoimmune basis for a subset of primary achalasia, and specifically targeting neuronal, glial, and muscle autoantigens.
Myelin basic protein as an encephalitogen in encephalomyelitis and polyneuritis following rabies vaccination.
Data implicate myelin basic protein as an encephalitogen in these autoimmune diseases of the human nervous system, but suggest that immune responses to cerebroside and certain gangliosides may have an augmentative role in severe disease.
Infections and autoimmune diseases.
  • J. Bach
  • Medicine, Biology
    Journal of autoimmunity
  • 2005
Paraneoplastic antibodies coexist and predict cancer, not neurological syndrome
The autoantibody profiles observed in patients with paraneoplastic disorders imply the targeting of multiple onconeural antigens and predict the patient's neoplasm, but not a specific neurological syndrome.
Neurologic complications of Semple‐type rabies vaccine
In three of six patients with encephalomyelitis, lymphocytes showed a proliferative response to myelin, and no clinical features, including CSF content of myelin basic protein, were prognostic indicators.
Incidence and prevalence of CIDP and the association of diabetes mellitus
The incidence and prevalence of chronic inflammatory demyelinating polyradiculoneuropathy in Olmsted County, Minnesota are similar to or higher than previous estimates, and the perceived association of DM with CIDP may be due to misclassification of other forms of diabetic neuropathies and excessive emphasis on electrophysiologic criteria.
Molecular Mimicry between Neurons and an Intracerebral Pathogen Induces a CD8 T Cell-Mediated Autoimmune Disease1
Molecular mimicry between a pathogen and neurons can induce aCD8 T cell-mediated neurological disease, with its severity being influenced by the frequency of specific CD8 T cells, and its induction, but not its symptomatic phase, requiring the intracerebral presence of the pathogen.
In experimental allergic encephalomyelitis (EAE), produced by injecting rabbits with whole rabbit spinal cord together with tubercle bacilli and mineral oil, lesions comparable to those seen in the