Rheumatic disorders developed after hepatitis B vaccination

Objective. To obtain an overview of rheumatic disorders occurring after hep atitis B vaccination. Methods. A questionnaire was sent to rheumatology departments in nine Frenc h hospitals. Criteria for entry were rheumatic complaints of 1 week's durat ion or more, occurrence during the 2 months following hepatitis B vaccinati on, no previously diagnosed rheumatic disease and no other explanation for the complaints. Results. Twenty-two patients were included. The observed disorders were as follows: rheumatoid arthritis for six patients; exacerbation of a previousl y non-diagnosed systemic lupus erythematosus for two; post-vaccinal arthrit is for five; polyarthralgia-myalgia for four; suspected or biopsy-proved va sculitis for three; miscellaneous for two. Conclusions. Hepatitis B vaccine might be followed by various rheumatic con ditions and might trigger the onset of underlying inflammatory or autoimmun e rheumatic diseases. However, a causal relationship between hepatitis B va ccination and the observed rheumatic manifestations cannot be easily establ ished. Further epidemiological studies are needed to establish whether hepa titis B vaccination is associated or not with an incidence of rheumatic dis orders higher than normal.