Severe pancytopenia triggered by recombinant hepatitis B vaccine
Severe pancytopenia triggered by recombinant hepatitis B vaccine
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DOI：
10.1046/j.1365-2141.2000.02171.x
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发表时间：
2000-07-01
影响因子：
6.5
通讯作者：
Pellegrin, JL
中科院分区：
文献类型：
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作者：
Viallard, JF;Boiron, JM;Pellegrin, JL
我们描述了一名青少年的病例，该青少年在第三次重组乙型肝炎疫苗加强接种后 3 周出现发烧、关节炎、皮肤血管炎和严重全血细胞减少症。骨髓检查显示缺乏晚期骨髓元素，随后成熟停滞。患者外周血单核细胞产生的干扰素-γ (IFN-γ) 显着增加。潜在的免疫倾向 (HLA-DR3) 可能间接使疫苗能够触发乙型肝炎病毒特异性细胞毒性 T 淋巴细胞反应。因此，全血细胞减少症可能是由 CD8(+) T 细胞区室失调通过增加 IFN-γ 产生而引起的。
We describe the case of a teenager who developed fever, arthritis, cutaneous vasculitis and severe pancytopenia 3 weeks after the third vaccination boost with a recombinant hepatitis B vaccine. Bone marrow examination showed paucity of late myeloid elements and, subsequently, maturation arrest. Interferon-gamma (IFN-gamma) production by peripheral blood mononuclear cells from the patient was dramatically increased, An underlying immune predisposition (HLA-DR3) may have indirectly enabled the vaccine to trigger a hepatitis B virus-specific cytotoxic T-lymphocyte response. It is therefore possible that the pancytopenia was induced by a dysregulation of the CD8(+) T-cell compartment via increased IFN-gamma production.