Key result
Hepatitis B vaccination with aluminic adjuvants was associated with the development of macrophagic myofasciitis in two identical twin sisters, suggesting a role for genetic susceptibility.
Case Report (n=2)
This case report suggests a possible genetic susceptibility to macrophagic myofasciitis triggered by aluminic vaccine adjuvants.
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Should not change hepatitis B vaccination practices; leaves open genetic susceptibility to aluminic adjuvants in macrophagic myofasciitis.
Introduction Macrophagic myofasciitis (MMF) is an inflammatory myopathy, recently described (1,2). Clinical symptoms include myalgias, arthralgias, muscle weakness, asthenia, and fever. Diagnosis is based on deltoid muscle biopsy that usually shows specific histologic abnormalities including infiltration of connective tissue structures by densely packed large and grossly rounded CD68 histiocytes. These cells are characterized by central, round, and often nucleolated nuclei, and clear, slightly basophilic cytoplasms with fine PAS-positive granules (1). Aluminic vaccine adjuvants (3) as well as Tropheryma whippelii infection (4,5) have been recently suggested as possible etiopathogenic agents of MMF. We report 2 cases of MMF observed after hepatitis B vaccination in twin sisters. This observation illustrates the importance of the genetic background in MMF, and its possible triggering by aluminic vaccines.
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Guis et al. (2002) conducted a case report in Macrophagic myofasciitis (n=2). Hepatitis B vaccination (aluminic vaccine adjuvants) was evaluated on Development of macrophagic myofasciitis. Hepatitis B vaccination with aluminic adjuvants was associated with the development of macrophagic myofasciitis in two identical twin sisters, suggesting a role for genetic susceptibility.
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