Chronic fatigue syndrome and fibromyalgia following immunization with the hepatitis B vaccine: another angle of the 'autoimmune (auto-inflammatory) syndrome induced by adjuvants' (ASIA).
http://www.ncbi.nlm.nih.gov/pubmed/25427994
Abstract
The
objectives of this study were to gather information regarding
demographic and clinical characteristics of patients diagnosed with
either fibromyalgia (FM) or chronic fatigue (CFS) following hepatitis B
vaccination (HBVv) and furthermore to apply the recently suggested
criteria of autoimmune (auto-inflammatory) syndromes induced by
adjuvants (ASIA), in the aim of identifying common characteristics that
may suggest an association between fibromyalgia, chronic fatigue and HBV
vaccination. Medical records of 19 patients with CFS and/or
fibromyalgia following HBVv immunization were analyzed. All of which
were immunized during 1990-2008 in different centers in the USA. All
medical records were evaluated for demographics, medical history, the
number of vaccine doses, as well as immediate and long term
post-immunization adverse events and clinical manifestations. In
addition, available blood tests, imaging results, treatments and
outcomes were analyzed. ASIA criteria were applied to all patients. The
mean age of patients was 28.6 ± 11 years, of which 68.4 % were females.
21.05 % had either personal or familial background of autoimmune
disease. The mean latency period from the last dose of HBVv to onset of
symptoms was 38.6 ± 79.4 days, ranging from days to a year. Eight
(42.1 %) patients continued with the immunization program despite
experiencing adverse events. Manifestations that were commonly reported
included neurological manifestations (84.2 %), musculoskeletal (78.9 %),
psychiatric (63.1 %), fatigue (63.1 %), gastrointestinal complains
(58 %) and mucocutaneous manifestations (36.8 %). Autoantibodies were
detected in 71 % of patients tested. All patients fulfilled the ASIA
criteria. This study suggests that in some cases CFS and FM can be
temporally related to immunization, as part of ASIA syndrome. The
appearance of adverse event during immunization, the presence of
autoimmune susceptibility and higher titers of autoantibodies all can be
suggested as risk factors. ASIA criteria were fulfilled in all patients
eluding the plausible link between ASIA and CFS/FM.
