Neau D, Bonnet F, Michaud M, Perel Y, Longy-Boursier M, Ragnaud J M, Guillard J M
Département de Maladies Infectieuses et Médecine Interne, Hôpital Pellegrin, Bordeaux, France.
Scand J Infect Dis. 1998;30(2):115-8. doi: 10.1080/003655498750003465.
Recombinant hepatitis B vaccine is usually well tolerated. Clinical and laboratory test manifestations with immunologic mechanisms have nonetheless been described following use of this vaccine. We retrospectively report 7 cases of thrombocytopenia occurring within 3 months (7 weeks on the average) of 1 or following injections of recombinant hepatitis B vaccine. Four boys and 3 girls, average age 12 y, were involved. Three had a history of immune thrombocytopenic purpura. Four had haemorrhagic manifestations. The haemogram showed thrombocytopenia (24 x 10(9)/l on the average) without alterations of the other lines. Infectious and immune aetiologies were excluded in all cases. The course varied after treatment by corticosteroids, high-dose intravenous immunoglobulin, or both. After describing the different manifestations subsequent to recombinant hepatitis B vaccination, we discuss post-vaccinal thrombocytopenias (vaccines in question, mechanisms) and the reality of this entity.
重组乙型肝炎疫苗通常耐受性良好。然而，使用该疫苗后仍有涉及免疫机制的临床和实验室检查表现被描述。我们回顾性报告了7例在接种1剂或多剂重组乙型肝炎疫苗后3个月内（平均7周）发生血小板减少症的病例。涉及4名男孩和3名女孩，平均年龄12岁。3例有免疫性血小板减少性紫癜病史。4例有出血表现。血常规显示血小板减少（平均24×10⁹/L），其他血细胞系无改变。所有病例均排除感染性和免疫性病因。经皮质类固醇、大剂量静脉注射免疫球蛋白或两者治疗后病程各异。在描述重组乙型肝炎疫苗接种后的不同表现后，我们讨论疫苗接种后血小板减少症（相关疫苗、机制）以及该实体的实际情况。
