Thursday, January 5, 2017
Human papillomavirus vaccination syndrome--small fiber neuropathy and dysautonomia
Vaccination has been one of the most effective public health measures in the history of medicine. However, seemingly inexplicit adverse reactions have been described after the injection of the newer vaccines vs. human papillomavirus (HPV). The symptoms more often reported are chronic pain with paresthesias, headaches, fatigue, and orthostatic intolerance. Adverse reactions appear to be more frequent after HPV vaccination when compared to other type of immunizations. Different isolated cases and small series have described the development of complex regional pain syndrome (CRPS), postural orthostatic tachycardia syndrome (POTS), and fibromyalgia after HPV vaccination. These are illnesses often difficult to diagnose that have overlapping clinical features. Sympathetic nervous system dysfunction seems to play a major role in the pathogenesis of these syndromes. Also, small fiber neuropathy has been recently recognized in CRPS, POTS, and fibromyalgia. This article forwards the hypothesis that small fiber neuropathy and dysautonomia could be the common underlying pathogenesis to the group of rare, but severe reactions that follow HPV vaccination. Clinicians should be aware of the possible association between HPV vaccination and the development of these difficult to diagnose painful dysautonomic syndromes.
Vaccination has been one of the most effective public health measures in the history of medicine http://www.cdc.gov/vaccines/ (accessed 6 April 2015). Terrible diseases such as smallpox or poliomyelitis have been practically eradicated. Nevertheless, it seems as the pendulum has swung too far. Nowadays, children are subjected to multiple vaccination protocols not only to prevent common infectious diseases but also to prevent the late appearance of cancer. The human papillomavirus (HPV) vaccine is the case in point . Different adverse reactions have been reported from several parts of the world after HPV vaccination. A patterned illness of chronic pain and autonomic dysfunction seems to be emerging from these reports [2–5]. Kinoshita et al.  and Brinth et al.  have recently published well-documented evidence of different expressions of sympathetic dysfunction in sizable groups of girls that received the HPV vaccine.
There appears to be a disconnection between the self-reported severe reactions that frequently appear in the social media blogs http://sanevax.org (accessed 4 April 2015), in contrast with the opinion of health authorities that classify the purported side effects as coincidental or not specific for a definite diagnosis . Some investigators have classified these post-vaccination responses as “mass psychogenic illness” . Nevertheless, during the last months, the medical scientific literature has documented case reports and small series describing severe adverse reactions to the HPV vaccine that might have common underlying pathogenesis. HPV vaccine-induced illnesses include complex regional pain syndrome (CRPS) , postural orthostatic tachycardia syndrome (POTS) [2–4], and fibromyalgia [8, 9], among others. These illnesses are often difficult to recognize. Various traditional physicians deny the mere existence of these syndromes disregarding them as somatization disorders or psychogenic illnesses [10, 11].
This piece proposes that HPV vaccine-induced small fiber neuropathy and dysautonomia could be the common underlying pathogenesis to the group of rare, but severe, reactions that follow HPV vaccination.
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