Premium
Severe pancytopenia triggered by recombinant hepatitis B vaccine
Author(s) -
Viallard JeanFrançois,
Boiron JeanMichel,
Parrens Marie,
Moreau JeanFrançois,
Ranchin Valérie,
Reiffers Josy,
Leng Bernard,
Pellegrin JeanLuc
Publication year - 2000
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2000.02171.x
Subject(s) - pancytopenia , medicine , immunology , peripheral blood mononuclear cell , cytotoxic t cell , bone marrow , vaccination , cd8 , virology , immune system , biology , biochemistry , in vitro
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‐γ (IFN‐γ) 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‐γ production.