Rheumatology 1999; 38: 978-983
© 1999 British Society for Rheumatology
Rheumatic disorders developed after hepatitis B vaccination
Department of Rheumatology, Dijon University Hospital,
1 Department of Rheumatology, Strasbourg University Hospital,
2 Department of Rheumatology, Besançon University Hospital,
3 Department of Rheumatology, Centre Hospitalier Lyon-Sud,
4 Department of Rheumatology, Reims University Hospital,
5 Department of Internal Medicine, Dijon University Hospital,
6 Department of Rheumatology, Grenoble University Hospital and
7 Center of Pharmacovigilance, Dijon University Hospital, France
Correspondence to:
J. F. Maillefert, Department of Rheumatology, Hôpital Général, 3 rue du Fb Raines, 21000 Dijon, France.
Objective. To obtain an overview of rheumatic disorders occurring after hepatitis B vaccination.
Methods. A questionnaire was sent to rheumatology departments in nine French hospitals. Criteria for entry were rheumatic complaints of 1 week's duration or more, occurrence during the 2 months following hepatitis B vaccination, 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 previously non-diagnosed systemic lupus erythematosus for two; post-vaccinal arthritis for five; polyarthralgia–myalgia for four; suspected or biopsy-proved vasculitis for three; miscellaneous for two.
Conclusions. Hepatitis B vaccine might be followed by various rheumatic conditions and might trigger the onset of underlying inflammatory or autoimmune rheumatic diseases. However, a causal relationship between hepatitis B vaccination and the observed rheumatic manifestations cannot be easily established. Further epidemiological studies are needed to establish whether hepatitis B vaccination is associated or not with an incidence of rheumatic disorders higher than normal.
KEY WORDS: Hepatitis B vaccine, Adverse effects, Arthritis, Polyarthritis, Rheumatoid arthritis, Lupus erythematosus, Vasculitis.
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