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Semin Arthritis Rheum 1999 Dec;29(3):131-139 |
Can immunization precipitate connective
tissue disease? Report of five cases of systemic lupus erythematosus and review
of the literature.
Older SA, Battafarano DF, Enzenauer RJ, Krieg AM.
Rheumatology Service, Brooke Army Medical Center, and Veterans Affairs Medical
Center and Department of Medicine, University of Iowa, USA.
OBJECTIVES: To report a series of five patients who developed systemic lupus
erythematosus (SLE) after immunization and review the literature on
vaccine-associated connective tissue diseases and the theoretical mechanisms
that could explain such an association. METHODS: Uncontrolled retrospective
analysis of cases identified sporadically over 7 years at three centers.
RESULTS: In our series of 5 patients, symptoms of SLE developed within 2 to 3
weeks after secondary immunization. All patients met American College of
Rheumatology (ACR) criteria for the diagnosis of SLE. In most patients,
symptoms have been persistent. CONCLUSION: Although a coincidental association
between vaccination and the onset of SLE cannot be excluded, the temporal
relationship with the development of symptoms makes it immunologically
plausible that vaccination triggered systemic autoimmunity in these rare cases.
We propose that epidemiological studies be performed to examine this potential
association in more detail to quantitate the risk and identify possible genetic
risk factors.
Publication Types:
·
Review
·
Review of reported cases
PMID: 10622677 [PubMed - indexed for MEDLINE]