Arthritis following combined vaccine against diphtheria, polyomyelitis, and tetanus toxoid

Clin Exp Rheumatol. 2000 Mar-Apr;18(2):255-6.


We describe 2 cases of arthritis following immunization against diphtheria, poliomyelitis and tetanus toxoid. One patient developed monoarthritis of the knee after immunization, that regressed following synovectomy. Five years later, the arthritis recurred after a booster vaccine injection. One day after immunization, another patient developed arthritis of the ankle that persisted for 3 days. It is difficult to know whether there is a coincidental or a causal relation between immunization and arthritis. Although our cases suggest that immunization against diphtheria, poliomyelitis and tetanus toxoid may cause arthritis, additional cases must be reported before studies aimed at confirming this possibility are considered.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Ankle Joint / pathology
  • Ankle Joint / surgery
  • Arthritis, Infectious / etiology*
  • Arthritis, Infectious / pathology
  • Diphtheria Toxoid / adverse effects*
  • Female
  • Humans
  • Knee Joint / pathology
  • Knee Joint / surgery
  • Poliovirus Vaccine, Inactivated / adverse effects*
  • Tetanus Toxoid / adverse effects*
  • Vaccination / adverse effects*
  • Vaccines, Combined / adverse effects


  • Diphtheria Toxoid
  • Poliovirus Vaccine, Inactivated
  • Tetanus Toxoid
  • Vaccines, Combined