Subacute thyroiditis and dyserythropoesis after influenza vaccination suggesting immune dysregulation

• Published in: Boletin de la Asociación Médica de Puerto Rico Vol. 103; no. 2; p. 48
• Main Authors: Hernán Martinez, Jose, Corder, Eric, Uzcategui, Maria, Garcia, Martha, Sostre, Samuel, Garcia, Armando
• Format: Journal Article
• Language: English
• Published: Puerto Rico 01-04-2011
• Subjects: Anemia - etiology; Anemia - immunology; Autoantibodies - blood; Bone Marrow - pathology; Cytokines - biosynthesis; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - immunology; GATA1 Transcription Factor - biosynthesis; Genetic Predisposition to Disease; Goiter, Nodular - complications; HLA-B35 Antigen - analysis; HLA-B35 Antigen - genetics; Humans; Inflammation; Influenza Vaccines - adverse effects; Male; Middle Aged; Psoriasis - complications; Psoriasis - immunology; Thyroiditis, Autoimmune - etiology; Thyroiditis, Autoimmune - immunology; Thyroiditis, Autoimmune - pathology; Thyroiditis, Subacute - etiology; Thyroiditis, Subacute - immunology; Thyroiditis, Subacute - pathology; Vaccination; Vaccines, Attenuated - adverse effects
• ISSN: 0004-4849

Subacute thyroiditis (SAT) is an extremely rare complication of influenza vaccination. Several infectious agents have been related with SAT. It is also well known the association between HLA-B35 and the development of SAT. We describe a case of subacute thyroiditis and dyserythropoesis occurring shortly after administration of an influenza vaccine in a 55-year-old man with history of diabetes and psoriasis, family history of autoimmunity without clinical evidence of acute viral infection prior to the onset of symptoms. We propose that, the events occurring in the patient may be explained as result of complex interactions between the individual genetic background and environmental exposure to infectious agents that generated a pro-inflammatory status, where the vaccine was the trigger for the subsequent alterations in thyroid and bone marrow. These findings highlight the importance of immunogenetic factors involved in response to vaccination that is the central theme in the growing field of 'vaccinomics'.