title: Leukocytoclastic vasculitis and acute renal failure after influenza vaccination in an elderly patient with myelodysplastic syndrome.
abstract: BACKGROUND
  Influenza vaccination is recommended for individuals over 65 years of age and for all patients with chronic diseases who are at risk. Side effects which are seen in 1-10% of the vaccinated individuals are usually mild and consist of local reactions and constitutional symptoms. Since 1974, about 30 cases of vasculitis following influenza vaccination have been reported.
  
  
  METHODS
  We here describe a 70-year-old male patient with a 5-year history of myelodysplastic syndrome, who had received continuous steroid treatment since 2004 and presented with leukocytoclastic vasculitis and acute renal failure requiring hemodialysis therapy 1 week after influenza vaccination. High-dose steroid treatment was promptly initiated, but hemodialysis was needed for 9 days. Maintained steroid treatment for 2 weeks was associated with complete recovery of renal function and skin lesions.
  
  
  CONCLUSIONS
  As influenza vaccination is increasingly used, physicians should be aware of the potential serious side effect of leukocytoclastic vasculitis, particularly in patients who are immunocompromised either due to an underlying disorder or as a treatment-related side effect.
authors.affiliation: III. Medizinische Klinik, Fakultät für Klinische Medizin Mannheim der Universität Heidelberg, Germany.
authors.forename: Silke
authors.initials: S
authors.lastname: Ulm
authors.forename: Margit
authors.initials: M
authors.lastname: Hummel
authors.forename: Michael
authors.initials: M
authors.lastname: Emig
authors.forename: Manuel
authors.initials: M
authors.lastname: Barreto-Miranda
authors.forename: Walter
authors.initials: W
authors.lastname: Back
authors.forename: Andreas
authors.initials: A
authors.lastname: Reiter
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Hehlmann
authors.forename: Andreas
authors.initials: A
authors.lastname: Willer
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000175:diagnosis*; D006801:Humans; D007252:Influenza Vaccines / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000150:complications* / Q000175:diagnosis; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000139:chemically induced* / Q000175:diagnosis*
chemical_list: D007252:Influenza Vaccines