Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
, 27 (37), 5041-2

A Relapse of Systemic Type Juvenile Idiopathic Arthritis After a Rubella Vaccination in a Patient During a Long-Term Remission Period

Affiliations
Case Reports

A Relapse of Systemic Type Juvenile Idiopathic Arthritis After a Rubella Vaccination in a Patient During a Long-Term Remission Period

Seigo Korematsu et al. Vaccine.

Abstract

An 11-year-old female patient, whose systemic type juvenile idiopathic arthritis (JIA) had maintained in remission for the previous 4 years while taking only a small amounts of ibuprofen, showed an abrupt 2nd relapse with congestive heart failure five days after receiving a live-attenuated rubella vaccine, which was a primary immunization. Her serum levels of anti-rubella IgM and IgG antibodies increased, and her laboratory findings such as a leukocytosis, elevated serum levels of CRP, IL-6 and other inflammatory cytokine profiles were similar to the findings observed during her previous JIA active stage. After being administration of co-therapy with steroid pulse, ibuprofen, methotrexate and phosphodiesterase inhibitor gradually improved her clinical symptoms such as spiky fever, heart failure and arthralgia. Her intermittent fever and increased serum levels of CRP and IL-6, however, have been sustained for more than 2 years, and this prolonged active clinical course therefore differed from her previous JIA active stage.This abrupt relapse only five days after vaccination was suggested not to be directly related with rubella infection, but instead to be related with the molecular mimicry between rubella and JIA.

Similar articles

See all similar articles

Cited by 3 PubMed Central articles

  • Vaccinations in Paediatric Rheumatology: An Update on Current Developments
    N Groot et al. Curr Rheumatol Rep 17 (7), 46. PMID 26025339. - Review
    In 2011, the European League Against Rheumatism (EULAR) published recommendations regarding the vaccination of children with rheumatic diseases. These recommendations wer …
  • Vaccination in Paediatric Rheumatology
    JD Akikusa et al. Curr Rheumatol Rep 16 (8), 432. PMID 24925588. - Review
    As awareness of the risk of vaccine-preventable diseases for children with rheumatic diseases has increased, vaccination has become an important clinical consideration an …
  • Vaccinations in Juvenile Chronic Inflammatory Diseases: An Update
    CA Silva et al. Nat Rev Rheumatol 9 (9), 532-43. PMID 23820860. - Review
    Vaccination is a powerful tool to reduce the burden of infectious diseases in paediatric patients with chronic rheumatic diseases. Live attenuated vaccines are not recomm …

Publication types

Feedback