Nineteen cases of persistent pruritic nodules and contact allergy to aluminium after injection of commonly used aluminium-adsorbed vaccines
Nineteen cases of persistent pruritic nodules and contact allergy to aluminium after injection of commonly used aluminium-adsorbed vaccines
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DOI：
10.1007/s00431-005-1704-1
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发表时间：
2005-11-01
影响因子：
3.6
通讯作者：
Trollfors, B
中科院分区：
文献类型：
--
作者：
Bergfors, E;Björkelund, C;Trollfors, B
在使用几种铝吸附疫苗后，报告了罕见的持续性结核性结节病例，有时与铝（Al）过敏有关。在20世纪90年代的疫苗试验期间，在施用来自单一生产商的白喉-破伤风/无细胞百日咳（DT/aP）疫苗后，观察到与铝过敏相关的高结核病结节发病率（645例/76，000名接受者），其中77%与铝过敏相关。在本报告中，描述了19名接种氢氧化铝吸附DTaP/脊髓灰质炎+Hib（Infanrix，Pentavac）疫苗后出现结核性结节的儿童。这些儿童在注射部位有强烈的瘙痒结节，通常在上呼吸道感染和局部皮肤改变期间加重。到目前为止，这些症状已经持续了7年。接种疫苗和出现症状之间的中位时间为1个月。对16名儿童进行了铝过敏试验，所有儿童均出现阳性反应，表明对铝有迟发性超敏反应。这种情况并不常见，但重要的是要认识到，因为儿童和家庭可能会遭受相当大的痛苦。未来接种铝吸附疫苗可能会导致症状加重和铝过敏。含铝的皮肤产品，如止汗剂，可能会导致接触性皮炎。结节可能被误认为肿瘤。尽管Infanrix、Pentavac和其他铝吸附疫苗接种后瘙痒结节和铝过敏的发生率可能较低，但替代铝佐剂的研究似乎是适当的。我们得出结论，强烈瘙痒的皮下结节，持续多年，铝过敏可能会发生后DTaP/脊髓灰质炎+Hib疫苗接种的婴儿。
Rare cases of persistent pruritic nodules, sometimes associated with aluminium (Al) allergy, have been reported after the use of several Al adsorbed vaccines. During vaccine trials in the 1990s a high incidence of pruritic nodules (645 cases/76,000 recipients), in 77% associated with Al allergy, was observed after the administration of diphtheria-tetanus / acellular pertussis (DT/aP) vaccines from a single producer. In the present report 19 children with pruritic nodules after vaccination with Al hydroxide-adsorbed DTaP/polio+Hib (Infanrix, Pentavac) are described. The children had intensely itching nodules at the injection site, often aggravated during upper respiratory tract infections, and local skin alterations. So far, the symptoms have persisted for up to 7 years. The median time between vaccination and onset of symptoms was 1 month. 16 children were epicutaneously tested for Al, all with positive reactions indicating delayed hypersensitivity to Al. The condition is not commonly known but is important to recognise, as the child and the family may suffer considerably. Future vaccinations with Al-adsorbed vaccines may cause aggravation of the symptoms and the Al allergy. Al-containing skin products, such as antiperspirants, may cause contact dermatitis. Nodules may be mistaken for tumours. Even though the incidence of itching nodules and Al allergy after administration of Infanrix, Pentavac and other Al-adsorbed vaccines is probably low, research to replace Al adjuvants seems appropriate. We conclude that intensely itching subcutaneous nodules, lasting for many years, and hypersensitivity to aluminium may occur after DTaP/polio+Hib vaccination of infants.