Systemic polyarteritis nodosa following hepatitis B vaccination.
The authors report a patient who developed systemic polyarteritis nodosa two months after hepatitis B vaccination and review the literature concerning this vaccination and the development of autoimmune conditions, mainly vasculitis. A 14-year-old boy who had no relevant previous history and who was not taking any drugs presented with a livedo reticularis, fever, loss of weight, testicular pain, and paresthesias two months after receiving the third dose of a hepatitis B vaccination. Inflammatory parameters (ESR and CRP) were high. The patient met the ACR diagnostic criteria for polyarteritis nodosa. He received corticosteroids and immunosuppressants and showed improvement. After reviewing the 27 cases of vasculitis after hepatitis B vaccination reported in the current literature, the authors suggest that, in some cases, vaccination may be the triggering factor for vasculitis in individuals with a genetic predisposition. Physicians should be aware of this possible association.
de Carvalho
Jozélio Freire
JF
Rheumatology Division, São Paulo University School of Medicine, São Paulo, Brazil.
Pereira
Rosa Maria Rodrigues
RM
Shoenfeld
Yehuda
Y
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D019317:Evidence-Based Medicine; D017325:Hepatitis B Vaccines / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D010488:Polyarteritis Nodosa / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology*; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D017325:Hepatitis B Vaccines; D007166:Immunosuppressive Agents