Liver inflammation and acute respiratory distress syndrome in a patient receiving hepatitis B vaccine: a possible relationship?
We describe a patient in whom clinical evidence of liver and lung dysfunction developed after he received the second dose of recombinant hepatitis B vaccine, despite no serologic evidence of viral hepatitis. However, liver biopsy specimens demonstrated both surface antigens and core antigens, possibly indicating silent hepatitis B virus infection. A search for an infective etiology for the patient's subsequent clinical deterioration in lung function did not yield pathogens: postmortem examination revealed evidence of immune complex-mediated organ injury in the liver, lungs, and kidneys.
Ranieri
V M
VM
Istituto di Medicina Legale, Università di Bari, Ospedale Policlinico, Italy.
Dell'Erba
A
A
Gentile
A
A
Bruno
F
F
La Gioia
V
V
Spagnolo
A
A
Sacco
R
R
Caruso
G
G
Antonaci
S
S
Schiraldi
O
O
Brienza
A
A
D000936:Antigen-Antibody Complex; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D017809:Fatal Outcome; D017325:Hepatitis B Vaccines / Q000009:adverse effects*; D006801:Humans; D008099:Liver / Q000473:pathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000209:etiology*
D000936:Antigen-Antibody Complex; D017325:Hepatitis B Vaccines