Mitchell L A, Tingle A J, Shukin R, Sangeorzan J A, McCune J, Braun D K
Department of Pathology, University of British Columbia, Vancouver.
Arch Intern Med. 1993 Oct 11;153(19):2268-74.
Rubella immunization or infection is an uncommonly recognized cause of acute, recurrent, or persistent musculoskeletal manifestations. After routine rubella immunization, two women presented with the onset of polyarthralgia, arthritis, maculopapular rash, fever, paresthesia, and malaise with persistent or recurrent manifestations lasting longer than 24 months after vaccination. The patients expressed rubella virus RNA in peripheral-blood leukocytes 10 and 8 months after vaccination, respectively, in contrast to repeated negative results in asymptomatic rubella-immunized controls. One patient developed significantly depressed antibody responses to rubella virus after vaccination and experienced a prolonged clinical improvement after a 3-month course of intravenous immune globulin. The second patient had normal antibody responses to rubella virus and underwent no clinical improvement during or after intravenous immune globulin therapy. Rubella immunization or infection should be considered as additional causative factors in evaluation of acute and continuing musculoskeletal syndromes.
风疹免疫接种或感染是急性、复发性或持续性肌肉骨骼表现的一种罕见病因。在进行常规风疹免疫接种后，两名女性出现了多关节痛、关节炎、斑丘疹、发热、感觉异常和不适的症状，且在接种疫苗后持续或反复出现这些症状长达24个月以上。与无症状风疹免疫接种对照者反复出现阴性结果不同，这两名患者在接种疫苗后分别于第10个月和第8个月在外周血白细胞中检测到风疹病毒RNA。一名患者接种疫苗后对风疹病毒的抗体反应显著降低，在接受3个月的静脉注射免疫球蛋白治疗后临床症状得到了长期改善。第二名患者对风疹病毒的抗体反应正常，在静脉注射免疫球蛋白治疗期间或之后临床症状未得到改善。在评估急性和持续性肌肉骨骼综合征时，应将风疹免疫接种或感染视为额外的致病因素。
