Immune thrombocytopenic purpura after recombinant hepatitis B vaccine: retrospective study of seven cases.
Recombinant hepatitis B vaccine is usually well tolerated. Clinical and laboratory test manifestations with immunologic mechanisms have nonetheless been described following use of this vaccine. We retrospectively report 7 cases of thrombocytopenia occurring within 3 months (7 weeks on the average) of 1 or following injections of recombinant hepatitis B vaccine. Four boys and 3 girls, average age 12 y, were involved. Three had a history of immune thrombocytopenic purpura. Four had haemorrhagic manifestations. The haemogram showed thrombocytopenia (24 x 10(9)/l on the average) without alterations of the other lines. Infectious and immune aetiologies were excluded in all cases. The course varied after treatment by corticosteroids, high-dose intravenous immunoglobulin, or both. After describing the different manifestations subsequent to recombinant hepatitis B vaccination, we discuss post-vaccinal thrombocytopenias (vaccines in question, mechanisms) and the reality of this entity.
Neau
D
D
Département de Maladies Infectieuses et Médecine Interne, Hôpital Pellegrin, Bordeaux, France.
Bonnet
F
F
Michaud
M
M
Perel
Y
Y
Longy-Boursier
M
M
Ragnaud
J M
JM
Guillard
J M
JM
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France; D006509:Hepatitis B / Q000517:prevention & control; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007116:Immunization, Passive; D015994:Incidence; D008297:Male; D011379:Prognosis; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014614:Vaccines, Synthetic / Q000008:administration & dosage / Q000009:adverse effects*
D000305:Adrenal Cortex Hormones; D017325:Hepatitis B Vaccines; D014614:Vaccines, Synthetic