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Human Papilloma Virus Vaccine and Primary Ovarian Failure: Another Facet of the Autoimmune/Inflammatory Syndrome Induced by Adjuvants

Authors

  • Serena Colafrancesco,

    1. Zabludowicz Center for Autoimmune Diseases Sheba Medical Center, Tel-Hashomer, Israel
    2. Rheumatology Unit, Department of Internal Medicine and Medical Specialities, Sapienza University of Rome, Rome, Italy
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  • Carlo Perricone,

    1. Zabludowicz Center for Autoimmune Diseases Sheba Medical Center, Tel-Hashomer, Israel
    2. Rheumatology Unit, Department of Internal Medicine and Medical Specialities, Sapienza University of Rome, Rome, Italy
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  • Lucija Tomljenovic,

    1. Zabludowicz Center for Autoimmune Diseases Sheba Medical Center, Tel-Hashomer, Israel
    2. Neural Dynamics Research Group, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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  • Yehuda Shoenfeld

    Corresponding author
    1. Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
    • Zabludowicz Center for Autoimmune Diseases Sheba Medical Center, Tel-Hashomer, Israel
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Correspondence

Yehuda Shoenfeld, Department of Medicine B, Chaim Sheba Medical Center, Tel Hashomer, 52621, Israel. E-mail: Shoenfel@post.tau.ac.il

Abstract

Problem

Post-vaccination autoimmune phenomena are a major facet of the autoimmune/inflammatory syndrome induced by adjuvants (ASIA) and different vaccines, including HPV, have been identified as possible causes.

Method of study

The medical history of three young women who presented with secondary amenorrhea following HPV vaccination was collected. Data regarding type of vaccine, number of vaccination, personal, clinical and serological features, as well as response to treatments were analyzed.

Results

All three patients developed secondary amenorrhea following HPV vaccinations, which did not resolve upon treatment with hormone replacement therapies. In all three cases sexual development was normal and genetic screen revealed no pertinent abnormalities (i.e., Turner's syndrome, Fragile X test were all negative). Serological evaluations showed low levels of estradiol and increased FSH and LH and in two cases, specific auto-antibodies were detected (antiovarian and anti thyroid), suggesting that the HPV vaccine triggered an autoimmune response. Pelvic ultrasound did not reveal any abnormalities in any of the three cases. All three patients experienced a range of common non-specific post-vaccine symptoms including nausea, headache, sleep disturbances, arthralgia and a range of cognitive and psychiatric disturbances. According to these clinical features, a diagnosis of primary ovarian failure (POF) was determined which also fulfilled the required criteria for the ASIA syndrome.

Conclusion

We documented here the evidence of the potential of the HPV vaccine to trigger a life-disabling autoimmune condition. The increasing number of similar reports of post HPV vaccine-linked autoimmunity and the uncertainty of long-term clinical benefits of HPV vaccination are a matter of public health that warrants further rigorous inquiry.

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