This was put together in 1998 so it's a bit out of date, but it seems relevant.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