Plexus neuropathy following vaccination against tick-borne encephalitis and tetanus due to a sports related altered immune state.

A 45-year-old female patient who was practising sports on a competition level, developed a plexus neuropathy subsequent to a vaccination against tick-borne encephalitis (TBE) followed by an inoculation of tetanus toxoid six days later. After the TBE vaccination she continued to exercise intensely until symptoms of a neuritis were noticed. Pronounced endurance exercise has been described to alter the composition and function of the immune system. In our patient a decrease of T-helper cells and a significant lowered CD4/CD8 ratio could be detected. The possible link between an altered immune state and post-vaccinal neuropathy is discussed.