{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:36:07Z","timestamp":1790883367202,"version":"4.1.0"},"reference-count":13,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:00:00Z","timestamp":1732147200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pathology International"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We report the case of an 84\u2010year\u2010old male patient who was transferred to our hospital because of impaired consciousness and high fever, and died about 10 weeks after his fourth \u201ccoronavirus disease 2019\u201d (COVID\u201019) vaccination. Autopsy revealed acute ischemic change with microhemorrhage and perivascular T\u2010cell infiltration in the thalamus, pons, and cerebellum, which were considered to be related to neurological symptoms. There were dilatation of the right ventricle, accumulation of pleural effusion, and ascites, suggesting right heart failure. Although the patient had a negative COVID\u201019 polymerase chain reaction test, immunohistochemical analysis for severe acute respiratory syndrome coronavirus 2 (SARS\u2010CoV\u20102) antigens (spike and nucleocapsid proteins) was performed to identify the cause of death. Surprisingly, only SARS\u2010CoV\u20102 spike protein was detected in the thalamus, pons, and pituitary and adrenal glands. The presence of SARS\u2010CoV\u20102 spike protein might have been due to vaccination rather than viral infection, because no SARS\u2010CoV\u20102 nucleocapsid protein was detected. The spike protein in the central nervous system might have been related to the acute ischemic change, and that in the pituitary and adrenal glands may have been associated with right heart failure, possibly through dysfunction of the renin\u2010angiotensin\u2010aldosterone system.<\/jats:p>","DOI":"10.1111\/pin.13491","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T14:35:30Z","timestamp":1732199730000},"page":"697-703","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Multifocal meningoencephalitis after vaccination against COVID\u201019"],"prefix":"10.1111","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2978-2187","authenticated-orcid":false,"given":"Shuji","family":"Mikami","sequence":"first","affiliation":[{"name":"Department of Diagnostic Pathology National Hospital Organization Saitama Hospital Wako Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuru","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine National Hospital Organization Saitama Hospital Wako Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuhiro","family":"Yano","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine National Hospital Organization Saitama Hospital Wako Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichiro","family":"Hirayama","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine National Hospital Organization Saitama Hospital Wako Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Pathology, School of Medicine International University of Health and Welfare Narita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4250-1204","authenticated-orcid":false,"given":"Takayuki","family":"Shiomi","sequence":"additional","affiliation":[{"name":"Department of Pathology, School of Medicine International University of Health and Welfare Narita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiteru","family":"Tominaga","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine National Hospital Organization Saitama Hospital Wako Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Ishida","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology National Hospital Organization Saitama Hospital Wako Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-020-00459-7"},{"key":"e_1_2_10_3_1","unstructured":"World Health Organization (WHO). COVID\u201019 vaccine tracker and landscape.2023.https:\/\/www.who.int\/publications\/m\/item\/draft-landscape-of-covid-19-candidate-vaccines"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2101544"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-020-0603-3"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2021.36.e286"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2022.2082206"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines10101651"},{"key":"e_1_2_10_9_1","unstructured":"Centers for Disease Control and Prevention. Selected adverse events reported after COVID\u201019 vaccination.2024.https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/vaccines\/safety\/adverse-events.html"},{"key":"e_1_2_10_10_1","unstructured":"OdaY ShibaharaJ. Pathological autopsy of death cases after vaccination with the new coronavirus vaccine.2022.https:\/\/www.pathology.or.jp\/jigyou\/byouri_20220808-2.pdf"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(21)00291-6"},{"key":"e_1_2_10_12_1","first-page":"905","volume-title":"European Journal of Clinical Microbiology and Infectious Diseases","author":"Beyerstedt S","year":"2021"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41541-022-00439-3"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.isci.2023.106954"}],"container-title":["Pathology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pin.13491","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T14:30:07Z","timestamp":1734013807000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pin.13491"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,21]]},"references-count":13,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1111\/pin.13491"],"URL":"https:\/\/doi.org\/10.1111\/pin.13491","archive":["Portico"],"relation":{},"ISSN":["1320-5463","1440-1827"],"issn-type":[{"value":"1320-5463","type":"print"},{"value":"1440-1827","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,21]]},"assertion":[{"value":"2024-05-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}