INFLAMMATORY JOINT DISEASE AFTER IMMUNIZATIONS - A REPORT OF 2 CASES

Serious adverse effects of immunizations are uncommon, The hepatitis B vaccine has been implicated in a few dozen cases of extraarticular, s ystemic, or inflammatory joint disorders, We report two cases in which hepatitis A vaccination (Havrix(R), Smith Kline Beecham) was followed by a connective tissue disorder or a spondylarthropathy in two health y males aged 50 and 24 years, respectively, Both patients were BLA B27 -negative but carried the HLA DR1 and/or DR4 antigen, The outcome was favorable after treatment with a corticosteroid or a nonsteroidal anti inflammatory agent, The pathophysiology of immunization-related rheuma tic disorders may involve circulating immune complexes and/or a mechan ism similar to that seen in reactive arthritis, i.e., a genetically-de termined susceptibility to the bacterial or viral antigens contained i n vaccines.