title: Liver inflammation and acute respiratory distress syndrome in a patient receiving hepatitis B vaccine: a possible relationship?
abstract: 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.
authors.affiliation: Istituto di Medicina Legale, Università di Bari, Ospedale Policlinico, Italy.
authors.forename: V M
authors.initials: VM
authors.lastname: Ranieri
authors.forename: A
authors.initials: A
authors.lastname: Dell'Erba
authors.forename: A
authors.initials: A
authors.lastname: Gentile
authors.forename: F
authors.initials: F
authors.lastname: Bruno
authors.forename: V
authors.initials: V
authors.lastname: La Gioia
authors.forename: A
authors.initials: A
authors.lastname: Spagnolo
authors.forename: R
authors.initials: R
authors.lastname: Sacco
authors.forename: G
authors.initials: G
authors.lastname: Caruso
authors.forename: S
authors.initials: S
authors.lastname: Antonaci
authors.forename: O
authors.initials: O
authors.lastname: Schiraldi
authors.forename: A
authors.initials: A
authors.lastname: Brienza
mesh_terms: 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*
chemical_list: D000936:Antigen-Antibody Complex; D017325:Hepatitis B Vaccines