title: Macrophagic myofaciitis a vaccine (alum) autoimmune-related disease.
abstract: Macrophagic myofasciitis (MMF) is an immune-mediated condition first reported in 1998. MMF is characterized by post-vaccination systemic manifestations as well as local-stereotyped and immunologically active lesion in the site of inoculation (deltoid muscle). MMF systemic symptoms included myalgias, arthralgias, marked asthenia, muscle weakness, chronic fatigue, and fever. Recently, studies demonstrated that the local lesion is due to persistence for years at site of injection of an aluminum (Al(OH)3) adjuvant commonly used in human vaccines. Time elapsed from last immunization with an Al(OH)3-containing vaccine to muscle biopsy range from 3 months to 8 years; in rare cases, MMF may be diagnosed even 10 years post-vaccination. The discrepancy between the wide applications of aluminum hydroxide-containing vaccines and the very limited number of MMF cases reported may be resolved by observations suggesting that aluminum-containing vaccinations may trigger MMF in genetically susceptible subjects carrying the HLA-DRB1*01. Thus, MMF may be defined as an emerging novel condition that may be triggered by exposure to alum-containing vaccines, in patients with a specific genetic background, and this temporal association may be exhibited from a few months up to 10 years.
authors.affiliation: Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.
authors.forename: Eitan
authors.initials: E
authors.lastname: Israeli
authors.forename: Nancy
authors.initials: N
authors.lastname: Agmon-Levin
authors.forename: Miri
authors.initials: M
authors.lastname: Blank
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Shoenfeld
mesh_terms: D000276:Adjuvants, Immunologic / Q000009:adverse effects* / Q000737:chemistry; D000534:Alum Compounds / Q000009:adverse effects* / Q000737:chemistry; D018771:Arthralgia; D001327:Autoimmune Diseases / Q000139:chemically induced* / Q000235:genetics / Q000276:immunology / Q000503:physiopathology; D015551:Autoimmunity; D005208:Fasciitis / Q000139:chemically induced* / Q000235:genetics / Q000276:immunology / Q000503:physiopathology; D005221:Fatigue; D059647:Gene-Environment Interaction; D020022:Genetic Predisposition to Disease; D059811:HLA-DRB1 Chains / Q000235:genetics; D006801:Humans; D009220:Myositis / Q000139:chemically induced* / Q000235:genetics / Q000276:immunology / Q000503:physiopathology; D011110:Polymorphism, Genetic; D058408:Th1-Th2 Balance; D014611:Vaccination; D014612:Vaccines / Q000737:chemistry
chemical_list: D000276:Adjuvants, Immunologic; D000534:Alum Compounds; D059811:HLA-DRB1 Chains; C497841:HLA-DRB1*01 antigen; D014612:Vaccines