|
Br J Haematol 2000 Jul;110(1):230-233 |
Severe pancytopenia triggered by recombinant
hepatitis B vaccine.
Viallard JF, Boiron JM, Parrens M, Moreau JF, Ranchin V, Reiffers J, Leng B,
Pellegrin JL.
Clinique de Medecine Interne et Maladies Infectieuses, Service d'Hematologie,
Laboratoire d'Anatomopathologie, Hopital Haut-Leveque, Pessac, France.
JF.viallard@umr5540.u-bordeaux2.fr
We describe the case of a teenager who developed fever, arthritis, cutaneous
vasculitis and severe pancytopenia 3 weeks after the third vaccination boost
with a recombinant hepatitis B vaccine. Bone marrow examination showed paucity
of late myeloid elements and, subsequently, maturation arrest. Interferon-gamma
(IFN-gamma) production by peripheral blood mononuclear cells from the patient
was dramatically increased. An underlying immune predisposition (HLA-DR3) may
have indirectly enabled the vaccine to trigger a hepatitis B virus-specific
cytotoxic T-lymphocyte response. It is therefore possible that the pancytopenia
was induced by a dysregulation of the CD8+ T-cell compartment via increased
IFN-gamma production.
PMID: 10931005 [PubMed - indexed for MEDLINE]