Editing Acute disseminated encephalomyelitis (section)

==Causes==
Since the discovery of the anti-[[Myelin oligodendrocyte glycoprotein|MOG]] specificity against multiple sclerosis diagnosis<ref name="Reind_2013l">{{cite journal | vauthors = Reindl M, Di Pauli F, Rostásy K, Berger T | title = The spectrum of MOG autoantibody-associated demyelinating diseases | journal = Nature Reviews. Neurology | volume = 9 | issue = 8 | pages = 455–61 | date = August 2013 | pmid = 23797245 | doi = 10.1038/nrneurol.2013.118 | s2cid = 7219279 }}</ref> it is considered that ADEM is one of the possible clinical causes of [[anti-MOG associated encephalomyelitis]].<ref name="Weber_2018">{{cite journal | vauthors = Weber MS, Derfuss T, Brück W | title = Anti-Myelin Oligodendrocyte Glycoprotein Antibody-Associated Central Nervous System Demyelination-A Novel Disease Entity? | journal = JAMA Neurology | volume = 75 | issue = 8 | pages = 909–10 | date = August 2018 | pmid = 29913011 | doi = 10.1001/jamaneurol.2018.1055 | s2cid = 49303770 }}</ref>

There are several theories about how the anti-MOG antibodies appear in the patient's serum:
* A preceding antigenic challenge can be identified in approximately two-thirds of people.<ref name="Koelman_2015" /> Some viral infections thought to induce ADEM include [[Orthomyxoviridae|influenza virus]], [[dengue]],<ref>{{cite journal | vauthors = Kamel MG, Nam NT, Han NH, El-Shabouny AE, Makram AM, Abd-Elhay FA, Dang TN, Hieu NL, Huong VT, Tung TH, Hirayama K, Huy NT | display-authors = 6 | title = Post-dengue acute disseminated encephalomyelitis: A case report and meta-analysis | journal = PLOS Neglected Tropical Diseases | volume = 11 | issue = 6 | pages = e0005715 | date = June 2017 | pmid = 28665957 | pmc = 5509372 | doi = 10.1371/journal.pntd.0005715 | doi-access = free }}</ref> [[enterovirus]], [[measles]],<ref>{{cite journal | vauthors = Fisher DL, Defres S, Solomon T | title = Measles-induced encephalitis | journal = QJM | volume = 108 | issue = 3 | pages = 177–82 | date = March 2015 | pmid = 24865261 | doi = 10.1093/qjmed/hcu113 | doi-access = free }}</ref> [[mumps]], [[rubella]], [[varicella zoster]], [[Epstein–Barr virus]], [[cytomegalovirus]], [[herpes simplex virus]], [[hepatitis A]], [[coxsackievirus]] and [[COVID-19]].<ref name="Manikanta_2021" /><ref>{{cite news| vauthors = Sample I |date=2020-07-08|title=Warning of serious brain disorders in people with mild coronavirus symptoms|language=en-GB|work=The Guardian|url=https://www.theguardian.com/world/2020/jul/08/warning-of-serious-brain-disorders-in-people-with-mild-covid-symptoms|access-date=2020-07-08|issn=0261-3077}}</ref> Bacterial infections include [[Mycoplasma pneumoniae]], [[Borrelia burgdorferi]], [[Leptospira]], and [[Streptococcus#Beta-Hemolytic Streptococci|beta-hemolytic Streptococci]].<ref name="Tenembaum_2007">{{cite journal | vauthors = Tenembaum S, Chitnis T, Ness J, Hahn JS | title = Acute disseminated encephalomyelitis | journal = Neurology | volume = 68 | issue = 16 Suppl 2 | pages = S23–36 | date = April 2007 | pmid = 17438235 | doi = 10.1212/01.wnl.0000259404.51352.7f | s2cid = 19893165 | others = International Pediatric MS Study Group }}</ref>
* Exposure to vaccines: The only vaccine proven related to ADEM is the Semple form of the [[rabies]] vaccine,<ref name="Immunologic studies"/> but [[hepatitis B]],<ref>{{cite journal | vauthors = Karaali-Savrun F, Altintaş A, Saip S, Siva A | title = Hepatitis B vaccine related-myelitis? | journal = European Journal of Neurology | volume = 8 | issue = 6 | pages = 711–15 | date = November 2001 | pmid = 11784358 | doi = 10.1046/j.1468-1331.2001.00290.x | s2cid = 30784630 }}</ref> [[pertussis]], [[diphtheria]], measles, mumps, rubella,<ref name="m626">{{cite journal | last1=Kania | first1=Karolina | last2=Ambrosius | first2=Wojciech | last3=Tokarz Kupczyk | first3=Elzbieta | last4=Kozubski | first4=Wojciech | title=Acute disseminated encephalomyelitis in a patient vaccinated against SARS-CoV-2 | journal=Annals of Clinical and Translational Neurology | volume=8 | issue=10 | date=2021 | issn=2328-9503 | pmid=34480527 | pmc=8528462 | doi=10.1002/acn3.51447 | pages=2000–2003}}</ref> [[pneumococcus]], [[varicella]], influenza, [[Japanese encephalitis]], and [[polio]] vaccines have all been associated with the condition. <ref>{{cite journal | vauthors = Huynh W, Cordato DJ, Kehdi E, Masters LT, Dedousis C | title = Post-vaccination encephalomyelitis: literature review and illustrative case | journal = Journal of Clinical Neuroscience | volume = 15 | issue = 12 | pages = 1315–22 | date = December 2008 | pmid = 18976924 | pmc = 7125578 | doi = 10.1016/j.jocn.2008.05.002 }}</ref><ref>{{cite journal |vauthors=Rust RS |title=Multiple sclerosis, acute disseminated encephalomyelitis, and related conditions |journal=Seminars in Pediatric Neurology |volume=7 |issue=2 |pages=66–90 |date=June 2000 |pmid=10914409 |doi= 10.1053/pb.2000.6693}}</ref> The majority of the studies that correlate vaccination with ADEM onset use only small samples or are case studies.<ref name="x663">{{cite journal | last=Tenembaum | first=Silvia N. | title=Disseminated encephalomyelitis in children | journal=Clinical Neurology and Neurosurgery | publisher=Elsevier BV | volume=110 | issue=9 | year=2008 | issn=0303-8467 | doi=10.1016/j.clineuro.2007.12.018 | pages=928–938| pmid=18272282 | pmc=7116932 }}</ref> Large-scale epidemiological studies (e.g., of MMR vaccine or smallpox vaccine) do not show increased risk of ADEM following vaccination.<ref name="Leake_2004" /><ref name="Hemachudha_1987">{{cite journal | vauthors = Hemachudha T, Griffin DE, Giffels JJ, Johnson RT, Moser AB, Phanuphak P | title = Myelin basic protein as an encephalitogen in encephalomyelitis and polyneuritis following rabies vaccination | journal = The New England Journal of Medicine | volume = 316 | issue = 7 | pages = 369–74 | date = February 1987 | pmid = 2433582 | doi = 10.1056/NEJM198702123160703 }}</ref><ref name="Immunologic studies">{{cite journal | vauthors = Hemachudha T, Griffin DE, Johnson RT, Giffels JJ | title = Immunologic studies of patients with chronic encephalitis induced by post-exposure Semple rabies vaccine | journal = Neurology | volume = 38 | issue = 1 | pages = 42–44 | date = January 1988 | pmid = 2447520 | doi = 10.1212/WNL.38.1.42 | s2cid = 21992894 }}</ref><ref name="Murthy_2002">{{cite journal | vauthors = Murthy JM | title = Acute disseminated encephalomyelitis | journal = Neurology India | volume = 50 | issue = 3 | pages = 238–43 | date = September 2002 | pmid = 12391446 | url = http://www.neurologyindia.com/article.asp?issn=0028-3886;year=2002;volume=50;issue=3;spage=238;epage=43;aulast=Murthy }}</ref><ref name="Tenembaum_2002">{{cite journal | vauthors = Tenembaum S, Chamoles N, Fejerman N | title = Acute disseminated encephalomyelitis: a long-term follow-up study of 84 pediatric patients | journal = Neurology | volume = 59 | issue = 8 | pages = 1224–31 | date = October 2002 | pmid = 12391351 | doi = 10.1212/WNL.59.8.1224 | s2cid = 37405227 }}</ref><ref name="Fenichel_1982">{{cite journal | vauthors = Fenichel GM | title = Neurological complications of immunization | journal = Annals of Neurology | volume = 12 | issue = 2 | pages = 119–28 | date = August 1982 | pmid = 6751212 | doi = 10.1002/ana.410120202 | s2cid = 2352985 }}</ref><ref>{{cite journal | vauthors = Takahashi H, Pool V, Tsai TF, Chen RT | title = Adverse events after Japanese encephalitis vaccination: review of post-marketing surveillance data from Japan and the United States. The VAERS Working Group | journal = Vaccine | volume = 18 | issue = 26 | pages = 2963–69 | date = July 2000 | pmid = 10825597 | doi = 10.1016/S0264-410X(00)00111-0 | url = https://zenodo.org/record/1259957 }}</ref><ref>{{cite journal | vauthors = Tourbah A, Gout O, Liblau R, Lyon-Caen O, Bougniot C, Iba-Zizen MT, Cabanis EA | title = Encephalitis after hepatitis B vaccination: recurrent disseminated encephalitis or MS? | journal = Neurology | volume = 53 | issue = 2 | pages = 396–401 | date = July 1999 | pmid = 10430433 | doi = 10.1212/WNL.53.2.396 | s2cid = 25061061 }}</ref><ref>{{cite journal | vauthors = Sejvar JJ, Labutta RJ, Chapman LE, Grabenstein JD, Iskander J, Lane JM | title = Neurologic adverse events associated with smallpox vaccination in the United States, 2002–2004 | journal = JAMA | volume = 294 | issue = 21 | pages = 2744–50 | date = December 2005 | pmid = 16333010 | doi = 10.1001/jama.294.21.2744 | doi-access =  }}</ref><ref>{{cite journal | vauthors = Ozawa H, Noma S, Yoshida Y, Sekine H, Hashimoto T | title = Acute disseminated encephalomyelitis associated with poliomyelitis vaccine | journal = Pediatric Neurology | volume = 23 | issue = 2 | pages = 177–79 | date = August 2000 | pmid = 11020647 | doi = 10.1016/S0887-8994(00)00167-3 }}</ref> An upper bound for the risk of ADEM from [[measles vaccine|measles vaccination]], if it exists, can be estimated to be 10 per million,<ref name=NAP_vaccination>{{cite book|title=Adverse Events Associated with Childhood Vaccines: Evidence Bearing on Causality| vauthors = Stratton KR, Howe CJ, Johnston Jr RB |date=1994|publisher=The National Academies Press|isbn=978-0-309-07496-4|pages=125–26| doi = 10.17226/2138 | pmid = 25144097 |url=http://www.nap.edu/read/2138/chapter/7#124|access-date=6 December 2015| collaboration = Institute of Medicine (US) Vaccine Safety Committee }}</ref> which is far lower than the risk of developing ADEM from an actual measles infection, which is about 1 per 1,000 cases. For a rubella infection, the risk is 1 per 5,000 cases.<ref name="Fenichel_1982" /><ref>{{cite journal | vauthors = Gibbons JL, Miller HG, Stanton JB | title = Para-infectious encephalomyelitis and related syndromes; a critical review of the neurological complications of certain specific fevers | journal = The Quarterly Journal of Medicine | volume = 25 | issue = 100 | pages = 427–505 | date = October 1956 | pmid = 13379602 }}</ref> Some early vaccines, later shown to have been contaminated with host animal central nervous system tissue, had ADEM incidence rates as high as 1 in 600.<ref name="Hemachudha_1987"/>
* In rare cases, ADEM seems to follow from [[organ transplant]]ation.<ref name="Tenembaum_2002" />