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This was put together in
1998 so it's a bit out of date, but it seems relevant. Note the large number of
studies in the "Central Nervous System DeMYELINation"
section. Interesting that at this time the links to arthritis were mostly case
reports. Funny how "anecdotal" evidence is still
evidence. -Dave
Abstracts on Hepatitis B
Vaccine
Dave Foster
: 1-12-98
Contents:
I. Overview
II. Central Nervous System Demyelination, Myelitis and
Inflammation
III. Various Adverse Reactions: Mostly Case
Reports
============
I. OVERVIEW
============
J Fam
Pract 1997 Oct;45(4):295-315;
quiz 317-8
Published erratum appears in
J Fam Pract 1997 Dec;45(6):464
Hepatitis B virus infection, hepatitis B vaccine,
and hepatitis B immune globulin.
Zimmerman RK, Ruben FL, Ahwesh ER
Department
of Family Medicine and Clinical Epidemiology,
University of
Pittsburgh
School
of Medicine, USA.
Hepatitis B virus (HBV)
infection is a major health problem in the United States; in 1995, approximately
128,000 cases occurred. Transmission of HBV occurs primarily by blood exchange
(eg, by shared needles during injection drug use) and
by sexual contact. Persons infected early in life are much more likely to
become chronically infected than those infected during
adulthood: as many as 90% of infants
infected perinatally develop chronic infection and up
to 25% will die of HBV-related chronic liver disease as adults. Clinical signs
of acute hepatitis occur in about 50% of infected adults but in only 5% of
infected preschool-aged children. In the United States, hepatitis B vaccine is
currently made by recombinant DNA technology using baker's yeast. Preexposure vaccination results in protective antibody
levels in almost all infants and children (> 95%) and healthy adults younger
than 40 years of age (> 90%). The most common adverse event following
administration of hepatitis B vaccine is pain at the injection site, which
occurs in 13% to 29% of adult and 3% to 9% of children. A comprehensive
hepatitis B vaccination policy is now recommended that includes (1) routine
infant vaccination; (2) catch-up vaccination of 11- to 12-year-olds who were
not previously vaccinated; (3) catch-up vaccination of young children at high
risk for infection; (4) vaccination of adolescents and adults based on
lifestyle or environmental, medical, and occupational situations that place
them at risk; and (5) prevention of perinatal HBV
infection.
PMID: 9343051, UI: 98002568
Vaccine 1998 Feb;16(4):329-34
Major adverse reactions to yeast-derived hepatitis B
vaccines--a review.
Grotto I, Mandel Y, Ephros M, Ashkenazi I, Shemer J
Israel Defense
Force, Medical Corps, Israel.
Yeast-derived recombinant
DNA hepatitis B vaccines usage became widely accepted since the early 1990s.
Severe adverse events have been reported infrequently in adults and rarely in
infants and children given hepatitis B vaccine in the ten years which have passed
since the introduction of the vaccine. Some of the data were summarized in
previous review articles. Our review of the literature revealed reports of
serious adverse reactions which included immediate reactions (anaphylaxis and urticaria) as well as delayed reactions, including skin,
rheumatic, vasculitic (including Systemic Lupus Erythematosus and glumerulonephritis),
hematologic, ophthalmologic and neurologic
reactions. These cases were summarized and a pathogenetic
mechanism is offered.
PMID: 9607051, UI: 98269934
Science 1998 Jul 31;281(5377):630-1
A shadow falls on hepatitis B vaccination effort.
Marshall E
PMID: 9714670, UI: 98370231
Lakartidningen 1996 Mar 6;93(10):883
[General vaccination against hepatitis B is not justified].
[Article in Swedish]
Oberg S
Infektionskliniken, Uddevalla sjukhus.
PMID: 8656789, UI: 96248664
Can Commun
Dis Rep 1992 Apr 17;18(7):49-53
Adverse events following the administration of
hepatitis B vaccines.
Bentsi-Enchill A
University of
Ottawa.
PMID: 1291014, UI: 93177423
Vaccine 1993 Oct;11(13):1358-9
Serious hepatitis B vaccine adverse reactions, are they
immune-mediated?
Carmeli Y, De-Medina T
Publication Types:
* Letter
PMID: 8296488, UI: 94127088
=====================================================================
II. Central Nervous System Demyelination, Myelitis and
Inflammation
=====================================================================
Postgrad Med J 1997 Jul;73(861):462-3
Hepatitis B vaccine and neurotoxicity.
Pirmohamed M, Winstanley
P
CSM Mersey Regional
Monitoring Centre, Pharmacy Practice Unit, Liverpool, UK.
PMID: 9338045, UI: 97479393
Lancet 1991 Nov 9;338(8776):1174-5
Central-nervous-system demyelination
after immunisation with recombinant hepatitis B
vaccine.
Herroelen L, de Keyser J, Ebinger G
Department of Neurology,
University Hospital, Free
University of Brussels, Belgium.
2 patients had neurological
symptoms and signs, with evidence of central-nervous-system demyelination,
6 weeks after administration of recombinant hepatitis B vaccine. 1 had known
multiple sclerosis but the other had no history of neurological disease; both
had HLA haplotypes DR2 and B7, which are associated
with multiple sclerosis. A causal link between vaccination and demyelination cannot be established from these 2
case-reports, but the time interval would fit a proposed immunological
mechanism.
Comments:
* Comment in: Lancet 1992 Jan 18;339(8786):178-9
PMID: 1682594, UI: 92047879
J Neurol
Neurosurg Psychiatry 1995 Jun;58(6):758-9
Central nervous system demyelination
after vaccination against hepatitis B and HLA haplotype.
Kaplanski G, Retornaz
F, Durand J, Soubeyrand J
Publication Types:
* Letter
PMID: 7608688, UI: 95332874
Neurology 1978 Sep;28(9 Pt 2):111-4
Viral models of demyelination.
Weiner LP, Stohlman SA
PMID: 568744, UI: 79053490
AJNR Am J Neuroradiol 1995 Mar;16(3):581-2
MR imaging in a case of postvaccination
myelitis.
Tartaglino LM, Heiman-Patterson
T, Friedman DP, Flanders AE
Department
of Radiology, Jefferson
Medical
College,
Philadelphia,
Pa.
19107, USA.
We describe a case of acute
transverse myelitis after the administration of the
recombinant form of hepatitis B vaccine. Abnormal enhancement of MR imaging
accompanied residual neurologic deficit.
PMID: 7793384, UI: 95313683
Presse Med 1993 Dec 18;22(40):1997-8
[Acute myelitis after
vaccination against hepatitis B].
[Article in French]
Mahassin F, Algayres
JP, Valmary J, Bili H, Coutant G, Bequet D, Daly JP
Service de
Clinique medicale, Hopital d'Instruction des Armees du Val-de-Grace,
Paris.
A 56-year old man was
hospitalized for spasmodic paraparesis with sphincter
disorders. After exclusion of spinal cord compression and all other
inflammatory, infectious or neoplastic causes, the
possibility of a connexion with an
hepatitis B vaccination performed with a recumbent vaccine three weeks before
the neurological disorders appeared was considered. The pathogenesis of such a myelitis remains uncertain. It
is based on the possible reactivation of a dormant virus or a crossed antigenic
reaction between a protein of the vaccine and the nervous system. The course of
the disease is usually favourable. The frequency of this
complication would be more accurately determined if all neurological
manifestations occurring after hepatitis B vaccination were reported.
PMID: 8127802, UI: 94173824
J Korean Med Sci 1997 Jun;12(3):249-51
Acute Myelitis after
hepatitis B vaccination.
Song HK, Kim HC, Yun YH
Department
of Neurology, Hallym
University
Medical
College, Kangdong Sacred Heart
Hospital,
Seoul, Korea.
We report a case of myelitis after plasma-derived hepatitis B vaccination. The
patient was a 31-year-old man who presented with progressive sensory symptoms
in extremities that developed 2 weeks after a third vaccination. MRI of the cervicothoracic region revealed swelling and T2 high signal
at the level of C4 to C5 cord, and isolated enhancement in the posterior
columns between C4 and C5 cord. The significance of MRI findings and HLA haplotype of the patient will be briefly discussed.
PMID: 9250923, UI: 97394595
Gastroenterol Clin
Biol 1996;20(4):401-2
[Acute myelitis after
immunization against hepatitis B with recombinant vaccine].
[Article in French]
Senejoux A, Roulot
D, Belin C, Tsakiris L, Rautureau J, Coste T
Publication Types:
* Letter
PMID: 8758508, UI: 96332745
J Hepatol
1993 Sep;19(2):317-8
Transverse myelitis
following hepatitis B vaccination.
Trevisani F, Gattinara
GC, Caraceni P, Bernardi M,
Albertoni F, D'Alessandro R, Elia
L, Gasbarrini G
Publication Types:
* Letter
PMID: 8301068, UI: 94132548
Presse Med 1997 Mar 8;26(7):328
[Acute aseptic meningitis after hepatitis B
vaccination].
[Article in French]
Heinzlef O, Moguilewski
A, Roullet E
Publication Types:
* Letter
PMID: 9122145, UI: 97252911
Presse Med 1996 Oct 26;25(32):1561-2
[Meningeal reaction after
vaccination against hepatitis B].
[Article in French]
Marsaudon E, Barrault
MF
Publication Types:
* Letter
PMID: 8952667, UI: 97110516
Am J Ophthalmol
1996 Sep;122(3):431-2
Multiple evanescent white dot syndrome
after hepatitis B vaccine.
Baglivo E, Safran
AB, Borruat FX
Department
of Ophthalmology, Geneva University Hospital, Switzerland.
baglivo-edoardo@diogenes.hcuge.ch
PURPOSE: Hepatitis B vaccine
has become an effective means of preventing complications of hepatitis B.
However, it occasionally induces serious side effects. We report a case of
multiple evanescent white dot syndrome (MEWDS) that
occurred following hepatitis B vaccination. METHODS: A 23-year-old woman with a
one-week history of progressive loss of vision in the left eye and bilateral photopsia was referred for examination. Her symptoms
appeared 24 hours after a booster intramuscular injection of hepatitis B
vaccine.
RESULTS: Clinical
examination, fluorescein angiography, and the course
of events were typical of MEWDS. CONCLUSIONS: This case demonstrates the
occasional occurrence of MEWDS after hepatitis B vaccine and suggests that
hepatitis B virus immunization may be a risk factor for this retinal condition.
PMID: 8794720, UI: 96387180
Ann N Y Acad
Sci 1997 Dec 29;830:319-21
Sudden hearing loss in childhood consequent to hepatitis B
vaccination: a case report.
Orlando MP, Masieri
S, Pascarella MA, Ciofalo
A, Filiaci F
ENT
Clinic, University La Sapienza,
Rome, Italy.
PMID: 9616691, UI: 98279663
Clin Infect Dis
1993 Nov;17(5):928-9
Multiple sclerosis and hepatitis B vaccination.
Nadler JP
Publication Types:
* Letter
PMID: 8286645, UI: 94114816
Acta Neurol
Scand 1994 Jun;89(6):462-3
Acute cerebellar ataxia
after immunisation with recombinant hepatitis B
vaccine.
Deisenhammer F, Pohl P, Bosch S, Schmidauer C
Department
of Neurology, University of Innsbruck, Austria.
We report one woman with
acute cerebellar ataxia (ACA), a well-defined
clinical syndrome, which occurred 10 days after the second vaccination with
recombinant hepatitis B vaccine. The patient had no previous symptoms or signs
of neurological disease and there was no evidence of neurologic
disease in the family history. Within nine months the symptoms remitted
completely according to other reports of ACA. As there was a close temporal
connection and no noticeable other cause we assume a causal link between the
vaccination and the disease. As far as we know this is the first case of ACA
after hepatitis B vaccination.
PMID: 7976236, UI: 95066735
Lancet 1993 Aug 28;342(8870):563-4
Visual loss and eosinophilia
after recombinant hepatitis B vaccine.
Brezin A, Lautier-Frau
M, Hamedani M, Rogeaux O,
Hoang PL
Publication Types:
* Letter
Comments:
* Comment in: Lancet 1993 Oct 16;342(8877):998
PMID: 8102709, UI: 93360669
J Hepatol
1996 Jun;24(6):764-5
Leukoencephalitis after recombinant hepatitis B vaccine.
Manna R, De Santis A, Oliviero A, Carnevale
A, Caputo S, Pahor M, Laudisio
A, Gasbarrini G
Publication Types:
* Letter
PMID: 8835755, UI: 96432703
=====================================================
III. Various Adverse
Reactions: Mostly Case Reports
=====================================================
Arch Dis
Child 1998 Mar;78(3):273-4
Thrombocytopenic purpura
as adverse reaction to recombinant hepatitis B vaccine.
Ronchi F, Cecchi
P, Falcioni F, Marsciani A,
Minak G, Muratori G, Tazzari PL, Beverini S
Divisione Pediatrica-Ospedale Civile di Cattolica (RN), Cattolica (RN), Italy.
Three cases of immune
thrombocytopenic purpura after the first dose of
recombinant hepatitis B vaccine occurred in infants under 6 months of age.
Other possible causes of this condition were excluded. Antiplatelet
antibodies were present. A defect in platelet production was excluded in two
children. Corticosteroid treatment was effective. Subsequent administration of
other vaccines (against polio, diphtheria, and tetanus) did not cause relapse
of thrombocytopenia.
PMID: 9613364, UI: 98276312
Eur J Dermatol
1998 Sep;8(6):435-6
Generalized granuloma annulare and hepatitis B vaccination.
Wolf F, Grezard
P, Berard F, Clavel G, Perrot H
Dermatology Department, Hopital de l'Antiquaille, rue de l'Antiquaille, 69321 Lyon Cedex
05, France.
As hepatitis B vaccination
is becoming generalized in Europe, cutaneous adverse
events are being more frequently reported in the literature. We report the
first case of generalized granuloma annulare following hepatitis B immunization. A 51-year-old
woman presented a generalized granuloma annulare one month after the one-year booster injection of
the hepatitis B vaccine. The lesions resolved with sulfone
therapy. We observed an identical recurrence three weeks after the five-year
booster.
PMID: 9729059, UI: 98398549
Lancet 1994 Nov 5;344(8932):1292-3
Liver dysfunction and DNA antibodies after hepatitis
B vaccination.
Lilic D,
Ghosh SK
Publication Types:
* Letter
PMID: 7967997, UI: 95057572
BMJ 1994 Dec 3;309(6967):1513
Reiter's syndrome attributed to hepatitis B immunisation.
Fraser PA, Wilson JD
Publication Types:
* Comment
* Letter
Comments:
* Comment on: BMJ 1994 Jul 9;309(6947):94
PMID: 7804068, UI: 95102375
Pediatr Dermatol
1994 Dec;11(4):363-4
Erythema multiforme following
hepatitis B vaccine.
Di Lernia
V, Lo Scocco G, Bisighini G
Publication Types:
* Letter
PMID: 7899194, UI: 95207066
Presse Med 1993 Feb 20;22(6):269
[Benign acute pericarditis
after vaccination against hepatitis B].
[Article in French]
Bensaid J, Denis F
Publication Types:
* Letter
PMID: 8511146, UI: 93288675
N Engl J Med 1996 Aug 1;335(5):355
Cryoglobulinemia after hepatitis B vaccination.
Mathieu E, Fain O, Krivitzky A
Publication Types:
* Letter
PMID: 8668224, UI: 96283165
Presse Med 1997 Feb 1;26(2):75
[Erosive polyarthritis triggered by
vaccination against hepatitis B].
[Article in French]
Soubrier M, Dubost
JJ, Bielsa C, Ristori JM, Bussiere JL
Publication Types:
* Letter
PMID: 9082414, UI: 97226581
Med J Aust
1996 Feb 5;164(3):187
Hepatitis B surface antigenaemia
in a child after vaccination.
Dickie AS, Olszewski
EH
Publication Types:
* Letter
Comments:
* Comment in: Med J Aust
1996 Apr 15;164(8):510
PMID: 8628142, UI: 96205691
Lancet 1993 Oct 16;342(8877):998
Eosinophilia after intradermal
hepatitis B vaccination.
Nagafuchi S, Tokiyama
K, Kashiwagi S, Yayashi S, Imayama S, Niho Y
Publication Types:
* Comment
* Letter
Comments:
* Comment on: Lancet 1993 Aug 28;342(8870):563-4
PMID: 8105253, UI: 94018194
Ann Dermatol
Venereol 1996;123(10):657-9
[Cutaneous lupus erythematosus and buccal aphthosis after hepatitis B vaccination in a 6-year-old
child].
[Article in French]
Grezard P, Chefai
M, Philippot V, Perrot H, Faisant M
Service de Dermatologie, Hopital de l'Hotel-Dieu, Lyon.
INTRODUCTION: Although the
hepatitis B vaccination tolerance is generally good, adverse effects, which are
specially neurologic and cutaneous,
have been observed and some cases of induced diseases with immunological
disorders have been reported. CASE REPORT: A 6 year-old boy presented a cutaneous lupus erythematosus and
a severe buccal aphthosis
following hepatitis B vaccination. There was no clinical or biological symptom
of systemic lupus erythematosus nor
of Behcet's disease. Under chloroquine
therapy, the cutaneous manifestations of lupus erythematosus disappeared quickly and those of buccal aphthosis improved.
DISCUSSION: Hepatitis B vaccination side effects are probably in relation with
a specific or non specific stimulation of the immune system. In our case,
cellular immunity is perhaps involved through the HBs
antigen. Considering the rarity of these side effects, an individual
predisposition seems very likely.
PMID: 9615128, UI: 98277333
Arch Dermatol
1994 Oct;130(10):1329-30
Lichen planus following hepatitis B
vaccination.
Aubin F, Angonin
R, Humbert P, Agache P
Publication Types:
* Letter
PMID: 7944523, UI: 95031207
Am J Med 1995 Jun;98(6):595-6
A case of severe cytolysis after hepatitis B
vaccination.
Germanaud J, Causse
X, Trinh DH, Pfau-Fandard B, Trepo
C
Publication Types:
* Comment
* Letter
Comments:
* Comment on: Am J Med 1992 Mar;92(3):254-6
PMID: 7778577, UI: 95297482
Presse Med 1996 Sep 28;25(28):1301
[Bilateral neuro-papillitis
after hepatitis B vaccination].
[Article in French]
Berkman N, Benzarti
T, Dhaoui R, Mouly P
Publication Types:
* Letter
PMID: 8949792, UI: 97107044
Rev Med Interne 1997;18(6):491-2
[Is hepatitis B vaccination a new cause of necrotizing vasculitis]?
[Article in French]
Kerleau JM, Levesque H, Lair G, Lecomte F, Carrara O, Courtois
H
Publication Types:
* Letter
PMID: 9247052, UI: 97390000
Ann Rheum Dis 1998 Apr;57(4):256-7
A case of Churg-Strauss vasculitis after hepatitis B vaccination.
Vanoli M, Gambini
D, Scorza R
Publication Types:
* Letter
PMID: 9709187, UI: 98374849
Presse Med 1997 Apr 26;26(14):670
[A case of segmentary
unilateral occlusion of the central retinal vein following hepatitis B
vaccination].
[Article in French]
Berkman N
Publication Types:
* Letter
PMID: 9180888, UI: 97324783
Lancet 1996 Jun 8;347(9015):1626
Occlusion of central retinal vein after hepatitis B
vaccination.
Devin F, Roques
G, Disdier P, Rodor F, Weiller PJ
Publication Types:
* Letter
PMID: 8667894, UI: 96240964
Presse Med 1998 Jun 6;27(20):965-6
[Hypersensitivity vasculitis
after hepatitis B vaccination].
[Article in French]
Masse I, Descoffres
MC
Publication Types:
* Letter
PMID: 9767839, UI: 98440953
Thorax 1993 May;48(5):580-1
Pulmonary and cutaneous vasculitis following hepatitis B vaccination.
Allen MB, Cockwell P, Page RL
St James's
University
Hospital, Leeds.
PMID: 8322254, UI: 93310736
Endocr J 1998 Feb;45(1):135
Subacute thyroiditis after
hepatitis B vaccination.
Toft J, Larsen S, Toft H
PMID: 9625459, UI: 98287141
Br J Rheumatol
1994 Oct;33(10):991
Acute sero-positive
rheumatoid arthritis occurring after hepatitis vaccination.
Vautier G, Carty
JE
Publication Types:
* Letter
Scand J Rheumatol
1995;24(1):50-2
Arthritis after hepatitis B vaccination. Report of three cases.
Gross K, Combe
C, Kruger K, Schattenkirchner M
Rheumatology
Unit, LM University of Munich, Germany.
Side effects of hepatitis
vaccination are rare. Only a few cases of arthritis after hepatitis vaccination
have been published. We report on three cases of vaccination-induced arthritis
with different resulting disease. Two cases show the pattern of reactive
arthritis. None of them was associated with HLA-B27. In the third case onset of
rheumatoid arthritis was triggered by hepatitis vaccination. These three cases
show that arthritis after hepatitis B vaccination probably is more common than
reported so far, especially in a genetically
predisposed subject (two of our patients expressed HLA-DR4).
PMID: 7863281, UI: 95167436
Br J Rheumatol
1997 Feb;36(2):300-1
Polyarthritis associated with hepatitis B vaccination.
Bracci M, Zoppini
A
Publication Types:
* Letter
PMID: 9133957, UI: 97279516
Clin Nephrol
1995 May;43(5):349
Nephrotic syndrome after recombinant hepatitis B vaccine.
Macario F, Freitas
L, Correia J, Campos M, Marques A
Publication Types:
* Letter
PMID: 7634556, UI: 95361242
Clin Infect Dis
1992 Dec;15(6):1051
Evans's syndrome triggered by recombinant hepatitis B vaccine.
Martinez E, Domingo P
Publication Types:
* Letter
PMID: 1457642, UI: 93091042
<< All opinions expressed are mine,
not the University's >>
=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
David Foster
Programmer/Analyst
dfoster@ucsd.edu
http://ncmir.ucsd.edu/
=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=
"The reasonable man adapts himself to
the world; the unreasonable one
persists in trying
to adapt the world to himself.
Therefore, all progress
depends on the
unreasonable." -- George Bernard
Shaw