Male Pseudohermaphroditism with XO Chromosomal Constitution on Bone-marrow Cells

of which there were no clinical or radiological signs.The S.G.O.T. remained normal.Three days after the onset of the chest pain the blood-pressure had risen to 130/80 mm.Hg and the electrocardiogram had become normal.On the tenth day after vaccination, when she showed a severe local reaction with axillary lymph adenopathy, she had a pyrexia of 1010 F. (38.30C.), transitory blurring of vision, and vomiting.These complications settled within 24 hours. COMMENTAlthough coronary artery disease, pulmonary embolism, and non-specific pericarditis cannot be conclusively excluded as possible causes of the acute cardiac disturb- ances in the cases described above, it is probable that these were complications of smallpox vaccination, which had taken place 5 to 14 days previously.Pericarditis has already been reported by Cangemi (1958), who described this in a 56-year-old man on the twentieth day after vaccination.The long time-lag in this patient led him to suggest that the complication was not due to direct invasion by the virus but an allergic effect due to antibody-antigen reaction.The shorter time-relations-hip in the above series suggests that the complication could equally well be due to a viraemia.SUMMARY Three cases are described of patients who presented with evidence of acute cardiac disease 5 to 14 days after vaccination.It is suggested that cardiological complica- tions of vaccination should be borne in mind if wide- spread vaccination for smallpox is reintroduced.We would like to thank Dr. E. W.