title: Acute metabolic crisis induced by vaccination in seven Chinese patients.
abstract: Seven Chinese patients (5 males and 2 females) with vaccination-induced acute metabolic crisis were reported. Only one male with 21-hydroxylase deficiency had been diagnosed before vaccination. In the remaining six patients, the preexisting diagnoses were not confirmed before the vaccination. Acute metabolic crisis occurred in seven patients between 3 and 12 hours after the administration of Japanese encephalitis, diphtheria, and tetanus toxoids and acellular pertussis, hepatitis B, or measles vaccines. Patients 1 and 2 displayed acute adrenal insufficiencies at the ages of 5 years and 3 months, respectively. Patient 3 had presented with mild motor retardation previously. Patients 4 to 7 were previously healthy, but suffered from fever, seizures, coma, acidosis, and hypoglycemia after being vaccinated. Glutaric aciduria type 1 was evident in case 4. Leigh syndromes were present in Patients 5, 6, and 7. They all died from respiratory failure before 2 years of age. Symmetric foci, cystic cavitations with neuronal loss, and vascular proliferation were observed by postmortem examination. Among the seven patients, although the vaccines were not the primary cause of the acute metabolic crisis, the severe acute episodes occurred coincidentally.
authors.affiliation: Department of Pediatrics, Peking University First Hospital, Beijing, China. yanlingy@vip.sina.com
authors.forename: Yanling
authors.initials: Y
authors.lastname: Yang
authors.forename: Sayami
authors.initials: S
authors.lastname: Sujan
authors.forename: Fang
authors.initials: F
authors.lastname: Sun
authors.forename: Yuehua
authors.initials: Y
authors.lastname: Zhang
authors.forename: Yuwu
authors.initials: Y
authors.lastname: Jiang
authors.forename: Jinqing
authors.initials: J
authors.lastname: Song
authors.forename: Jiong
authors.initials: J
authors.lastname: Qin
authors.forename: Xiru
authors.initials: X
authors.lastname: Wu
mesh_terms: D000137:Acid-Base Imbalance / Q000139:chemically induced* / Q000628:therapy; D044466:Asian People; D002675:Child, Preschool; D003128:Coma / Q000139:chemically induced; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008661:Metabolism, Inborn Errors / Q000175:diagnosis / Q000378:metabolism* / Q000628:therapy; D014612:Vaccines / Q000009:adverse effects*; D014883:Water-Electrolyte Imbalance / Q000139:chemically induced* / Q000628:therapy
chemical_list: D014612:Vaccines