title: Brief Report: Severe Inflammation Following Vaccination Against Streptococcus pneumoniae in Patients With Cryopyrin-Associated Periodic Syndromes.
abstract: OBJECTIVE
  Pneumococcal vaccination is recommended for patients receiving immunosuppressive drugs. We describe unusually severe adverse reactions to pneumococcal vaccination in each of 7 consecutive patients with cryopyrin-associated periodic syndromes (CAPS).
  
  
  METHODS
  Seven consecutive patients with CAPS were vaccinated with pneumococcal polysaccharide or conjugate vaccines. Clinical information was collected retrospectively.
  
  
  RESULTS
  Within a few hours after the vaccination, all 7 patients developed severe local reactions at the injection site. Two patients had to be hospitalized for systemic reactions including fever. All symptoms resolved in a period of 3-17 days.
  
  
  CONCLUSIONS
  Our findings indicate that pneumococcal vaccines can trigger a severe local and systemic inflammatory reaction in patients with CAPS and possibly patients with other autoinflammatory diseases. Careful consideration is warranted when implementing current European League Against Rheumatism immunization guidelines in this patient population.
authors.affiliation: Unispital Basel, Basel, Switzerland.
authors.forename: Ulrich A
authors.initials: UA
authors.lastname: Walker
authors.affiliation: University of California at San Diego.
authors.forename: Hal M
authors.initials: HM
authors.lastname: Hoffman
authors.affiliation: University College London, London, UK.
authors.forename: Rene
authors.initials: R
authors.lastname: Williams
authors.affiliation: University Hospital Tübingen, Tübingen, Germany.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Kuemmerle-Deschner
authors.affiliation: University College London, London, UK.
authors.forename: Philip N
authors.initials: PN
authors.lastname: Hawkins
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D002648:Child; D015331:Cohort Studies; D056587:Cryopyrin-Associated Periodic Syndromes / Q000188:drug therapy*; D005260:Female; D005334:Fever / Q000139:chemically induced*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007249:Inflammation / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000009:adverse effects*; D012189:Retrospective Studies; D013296:Streptococcus pneumoniae; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007166:Immunosuppressive Agents; D022242:Pneumococcal Vaccines; C541220:canakinumab