Coop Christopher A, Balanon Synya K, White Kevin M, Whisman Bonnie A, Rathkopf Melinda M
Department of Allergy/Immunology, Wilford Hall Medical Center, Lackland Air Force Base (AFB), San Antonio, Tex, USA.
Int Arch Allergy Immunol. 2008;146(1):85-8. doi: 10.1159/000112507. Epub 2007 Dec 14.
Allergic reactions to the influenza vaccine are uncommon and usually associated with sensitivity to egg or gelatin. The aim of this study was to report the case of anaphylaxis to the influenza vaccine.
Allergy percutaneous skin testing, serum specific IgE testing and IgE immunoblotting were performed to the influenza vaccine, egg, and gelatin.
Percutaneous skin testing to the influenza vaccine and gelatin were positive and egg (white, whole, and yolk) was negative. Immunocap serum-specific IgE testing to egg (white, whole, and yolk) and gelatin were negative (<0.35 kU/l). IgE immunoblots were performed with 2 cord blood serums and the patient's serum at a 1:20 dilution against 10 microg of the Fluzone influenza vaccine. The patient's IgE immunoblot showed a protein band at 100 kDa which is similar to the molecular weight of gelatin protein, a 68-kDa protein which is similar to the molecular weight of hemagglutinin protein from the influenza vaccine, and a 45-kDa protein band that is similar to the molecular weight of ovalbumin protein from chicken embryo/egg.
Based on clinical symptoms, skin testing, Immunocap testing and immunoblot evaluation, we feel that our patient is allergic to the infectious agent in the influenza vaccine as well as gelatin and ovalbumin in egg.
对流感疫苗的过敏反应并不常见,通常与对鸡蛋或明胶的敏感性有关。本研究的目的是报告一例流感疫苗过敏反应病例。
对流感疫苗、鸡蛋和明胶进行过敏皮肤点刺试验、血清特异性IgE检测和IgE免疫印迹分析。
流感疫苗和明胶的皮肤点刺试验呈阳性,鸡蛋(蛋清、全蛋和蛋黄)呈阴性。鸡蛋(蛋清、全蛋和蛋黄)和明胶的免疫化学发光法血清特异性IgE检测呈阴性(<0.35 kU/l)。用两份脐血血清和患者血清以1:20稀释度针对10微克的流感裂解疫苗进行IgE免疫印迹分析。患者的IgE免疫印迹显示在100 kDa处有一条蛋白带,与明胶蛋白的分子量相似;在68 kDa处有一条蛋白带,与流感疫苗血凝素蛋白的分子量相似;在45 kDa处有一条蛋白带,与鸡胚/鸡蛋卵清蛋白的分子量相似。
基于临床症状、皮肤试验、免疫化学发光法检测和免疫印迹评估,我们认为我们的患者对流感疫苗中的感染因子以及鸡蛋中的明胶和卵清蛋白过敏。