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European Journal of Dermatology. Vol. 13, Issue 1, January -
February 2003
Vaccine allergy and pseudo-allergy
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| European Journal of Dermatology. Vol. 13,
Issue 1, January - February 2003: 10-5, Review articles |
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Summary: Allergic and pseudo-allergic reactions
to vaccines frequently involve the skin, and can be
generalized systemic symptoms (urticaria/angioedema,
serum sickness, flares of eczema) or localized at the
sites of vaccination (persistent nodules, abcesses,
granulomas). Diagnosis of Arthus-type reactions is based
on clinical history and specific IgM/IgG anti-toxoid
determination. For other local reactions, diagnostic
value of non-immediate responses in skin tests varies
with clinical symptoms and substances involved.
Immediate responses in skin tests and specific IgE
determination have good diagnostic and/or predictive
value in anaphylaxis and immediate/accelerated
urticaria/angioedema to toxoid-, pneumococcus-, and egg-
and gelatin-containing vaccines. Diagnosis of reactions
to dextran in BCG is based on specific IgM/IgG
determination. Most non-immediate generalized reactions
result from non-specific inflammation, except for
gelatin-containing vaccines, but the diagnostic value of
immuno-allergological tests with the vaccines and
gelatin are controversial. Withholding booster
injections is advised if specific IgM/IgG levels are
high. If the levels are low, sequential injections of
vaccines containing a single vaccinating agent are
usually tolerated. However, injections of the vaccine
should be performed using a " desensitization "
procedure in patients reporting anaphylaxis and
immediate/accelerated urticaria/angioedema.
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| Author(s): Claude
PONVERT, Pierre SCHEINMANN |
Keywords: Allergy to
vaccines, dextran, gelatin, ovalbumin, pneumococcal
vaccine, toxoids, skin tests, specific IgE, specific
IgG. |
© John Libbey Eurotext |