Can immunization precipitate connective tissue disease? Report of fivecases of systemic lupus erythematosus and review of the literature
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Can immunization precipitate connective tissue disease? Report of five
cases of systemic lupus erythematosus and review of the literature
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.
"A foolish faith in authority is the worst enemy of truth."
-- Albert Einstein, letter to a friend, 1901
"I know of no safe depository of the ultimate powers of the society but the people themselves, and if we think them not enlightened enough to exercise control with a wholesome discretion, the remedy is not to take it from them, but to inform their discretion by education."
-- Thomas Jefferson, letter to William C. Jarvis, September 28, 1820
"What's the point of vaccination if it doesn't protect you from the unvaccinated?"
-- Sandy Gottstein
"Who gets to decide what the greater good is and how many will be sacrificed to it?"