The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Case of Systemic Lupus Erythematosus Occurring after H1N1 Influenza Vaccination

신종플루 백신 접종 후 발생한 전신성 홍반성 루푸스 1예

  • Jo, Seong Min (Department of Internal Medicine, Eulji University Hospital, Eulji University College of Medicine) ;
  • Shin, Jong Ho (Department of Internal Medicine, Eulji University Hospital, Eulji University College of Medicine) ;
  • Bang, Ki Tae (Department of Internal Medicine, Eulji University Hospital, Eulji University College of Medicine) ;
  • Jeong, Jin Uk (Department of Internal Medicine, Eulji University Hospital, Eulji University College of Medicine) ;
  • Kim, Nak Min (Department of Internal Medicine, Eulji University Hospital, Eulji University College of Medicine) ;
  • Choi, Ji Wook (Department of Internal Medicine, Eulji University Hospital, Eulji University College of Medicine) ;
  • Kim, Ju Hun (Department of Pathology, Eulji University Hospital, Eulji University College of Medicine)
  • 조성민 (을지대학교 의과대학 내과학교실) ;
  • 신종호 (을지대학교 의과대학 내과학교실) ;
  • 방기태 (을지대학교 의과대학 내과학교실) ;
  • 정진욱 (을지대학교 의과대학 내과학교실) ;
  • 김낙민 (을지대학교 의과대학 내과학교실) ;
  • 최지욱 (을지대학교 의과대학 내과학교실) ;
  • 김주헌 (을지대학교 의과대학 병리학교실)
  • Received : 2012.04.24
  • Accepted : 2012.07.11
  • Published : 2013.02.01
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Abstract

The recent worldwide outbreak of H1N1 has led to the universal administration of H1N1 influenza vaccination, including in South Korea. Several complications have been reported with use of H1N1 influenza vaccine, but systemic lupus erythematosus (SLE) has not been reported as a complication until now. Here, we report a case of SLE occurrence after H1N1 influenza vaccination. A 17-year-old girl who had not been diagnosed with SLE was hospitalized with fever, myalgia, and arthralgia after H1N1 influenza vaccination. Laboratory tests revealed increased levels of antinuclear antibody and anti-ds-DNA antibody, and decreased levels of C3 and C4 as well as proteinuria. The pathological findings confirmed a diagnosis of lupus nephritis. The patient was treated with high-dose corticosteroid and hydroxychloroquine. This is the first report of SLE following H1N1 influenza vaccination in South Korea.

저자들은 기존 병력이 없던 17세 여자 환자가 신종플루 백신 접종 후 루푸스가 발생하여 치료 후 호전된 첫 증례를 경험하여 보고하는 바이다.

Keywords

References

  1. World Health Organization. World now at the start of 2009 influenza pandemic [Internet]. Geneva: World Health Organization, c2009 [cited 2009 Jun 11]. Available from: http://www.who.int/mediacentre/news/statements/2009/h1n 1_pandemic_phase6_20090611/en/index.html 11 June 2009.
  2. Dubois EL, Tuffanelli DL. Clinical manifestations of systemic lupus erythematosus: computer analysis of 520 cases. JAMA 1964;190:104-111.
  3. Shoenfeld Y, Aron-Maor A. Vaccination and autoimmunity- 'vaccinosis': a dangerous liaison? J Autoimmun 2000;14: 1-10. https://doi.org/10.1006/jaut.1999.0346
  4. Wraith DC, Goldman M, Lambert PH. Vaccination and autoimmune disease: what is the evidence? Lancet 2003; 362:1659-1666. https://doi.org/10.1016/S0140-6736(03)14802-7
  5. Del Porto F, Laganà B, Biselli R, et al. Influenza vaccine administration in patients with systemic lupus erythematosus and rheumatoid arthritis: safety and immunogenicity. Vaccine 2006;24:3217-3223. https://doi.org/10.1016/j.vaccine.2006.01.028
  6. Chen RT, Rastogi SC, Mullen JR, et al. The vaccine adverse event reporting system (VAERS). Vaccine 1994;12:542-550. https://doi.org/10.1016/0264-410X(94)90315-8
  7. Greenberg ME, Lai MH, Hartel GF, et al. Response to a monovalent 2009 influenza A (H1N1) vaccine. N Engl J Med 2009;361:2405-2413. https://doi.org/10.1056/NEJMoa0907413
  8. Fox RA. Disseminated lupus erythematosus: an allergic disease? Arch Pathol 1943;36:311-315.
  9. Ayvazian LF, Badger TL. Disseminated lupus erythematosus occurring among student nurses. N Engl J Med 1948;239:565-570. https://doi.org/10.1056/NEJM194810142391601
  10. Tudela P, Martí S, Bonal J. Systemic lupus erythematosus and vaccination against hepatitis B. Nephron 1992;62:236. https://doi.org/10.1159/000187043