Vol.21 No.4

Case Report

Onset of adult-onset Still’s disease following influenza vaccination

Authors

Katsunobu Yoshioka1 , Shunsuke Fujimoto2 , Hiroko Oba2 , Mieko Minami1 , Tetsuya Aoki2

  • Department of Internal Medicine, Osaka City Sumiyoshi Hospital, 1-2-16 Higashikagaya, Suminoe-ku, Osaka Osaka, 559-0012, Japan
  • Department of Gastroenterology, Osaka City Sumiyoshi Hospital, Osaka, Osaka, Japan
Received:

10 December 2010

Accepted:

11 January 2011

Published online:

15 February 2011

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Abstract

We describe that case of a 61-year-old woman who developed high spiking fever, sore throat, polyarthralgia, and salmon pink evanescent rash following influenza vaccination. A diagnosis of adult-onset Still’s disease (AOSD) was made based on clinical and laboratory findings. Methylprednisolone pulse therapy followed by oral prednisolone resulted in a favorable outcome. This is the second published case in which a causal relationship between vaccination and onset of AOSD is suggested. Bystander activation would appear to play an important role in inducing the immune reaction.

Key words

Adult onset Still’s disease - Influenza vaccine - Cytokines - Bystander activation