title: Subacute thyroiditis and dyserythropoesis after influenza vaccination suggesting immune dysregulation.
abstract: Subacute thyroiditis (SAT) is an extremely rare complication of influenza vaccination. Several infectious agents have been related with SAT. It is also well known the association between HLA-B35 and the development of SAT. We describe a case of subacute thyroiditis and dyserythropoesis occurring shortly after administration of an influenza vaccine in a 55-year-old man with history of diabetes and psoriasis, family history of autoimmunity without clinical evidence of acute viral infection prior to the onset of symptoms. We propose that, the events occurring in the patient may be explained as result of complex interactions between the individual genetic background and environmental exposure to infectious agents that generated a pro-inflammatory status, where the vaccine was the trigger for the subsequent alterations in thyroid and bone marrow. These findings highlight the importance of immunogenetic factors involved in response to vaccination that is the central theme in the growing field of 'vaccinomics'.
authors: Microbiology and Immunology Department, San Juan Bautista School of Medicine, San Juan Bautista Medical Center, Caguas, Puerto Rico. jhernan.martinez@gmail.com
authors: Jose
authors: J
authors: Hernán Martinez
authors: Eric
authors: E
authors: Corder
authors: Maria
authors: M
authors: Uzcategui
authors: Martha
authors: M
authors: Garcia
authors: Samuel
authors: S
authors: Sostre
authors: Armando
authors: A
authors: Garcia
mesh_terms: D000740:Anemia / Q000209:etiology* / Q000276:immunology; D001323:Autoantibodies / Q000097:blood; D001853:Bone Marrow / Q000473:pathology; D016207:Cytokines / Q000096:biosynthesis; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000276:immunology; D050982:GATA1 Transcription Factor / Q000096:biosynthesis; D020022:Genetic Predisposition to Disease; D006044:Goiter, Nodular / Q000150:complications; D015797:HLA-B35 Antigen / Q000032:analysis* / Q000235:genetics; D006801:Humans; D007249:Inflammation; D007252:Influenza Vaccines / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000150:complications / Q000276:immunology; D013967:Thyroiditis, Autoimmune / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D013968:Thyroiditis, Subacute / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D014611:Vaccination; D014613:Vaccines, Attenuated / Q000009:adverse effects
chemical_list: D001323:Autoantibodies; D016207:Cytokines; D050982:GATA1 Transcription Factor; C494688:GATA1 protein, human; D015797:HLA-B35 Antigen; D007252:Influenza Vaccines; D014613:Vaccines, Attenuated; C006606:anti-thyroglobulin