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流感疫苗接种后出现亚急性甲状腺炎和红细胞生成异常,提示免疫调节异常。

Subacute thyroiditis and dyserythropoesis after influenza vaccination suggesting immune dysregulation.

作者信息

Hernán Martinez Jose, Corder Eric, Uzcategui Maria, Garcia Martha, Sostre Samuel, Garcia Armando

机构信息

Microbiology and Immunology Department, San Juan Bautista School of Medicine, San Juan Bautista Medical Center, Caguas, Puerto Rico.

出版信息

Bol Asoc Med P R. 2011 Apr-Jun;103(2):48-52.

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'.

摘要

亚急性甲状腺炎(SAT)是流感疫苗接种极为罕见的并发症。几种感染因子与SAT有关。HLA - B35与SAT的发生之间的关联也广为人知。我们描述了一例55岁男性在接种流感疫苗后不久发生亚急性甲状腺炎和红细胞生成异常的病例,该男性有糖尿病和银屑病病史,有自身免疫家族史,症状出现前无急性病毒感染的临床证据。我们认为,患者身上发生的事件可能是个体遗传背景与接触感染因子的环境之间复杂相互作用的结果,这种相互作用产生了促炎状态,而疫苗是随后甲状腺和骨髓发生改变的触发因素。这些发现凸显了免疫遗传因素在疫苗接种反应中的重要性,这是“疫苗组学”这一不断发展的领域的核心主题。

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