Background: Although influenza vaccines are generally safe and effective, a variety of autoimmune phenomena have been reported after vaccination over the past years, such as Guillain-Barre syndrome, rheumatoid arthritis, pemphigus vulgaris, psoriasis, giant cell arteritis and anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV). Case report: We describe the case of a 67-year old man who presented with a myeloperoxidase-ANCA associated vasculitis with renal involvement and mononeuritis multiplex after seasonal influenza vaccination. He was initially treated with intravenous cyclophosphamide and high-dose prednisolone followed by maintenance treatment consisting of azathioprine and prednisolone. Conclusion: We hypothesize that seasonal influenza vaccination triggered a systemic immune response in a susceptible patient to develop AAV with renal involvement and vasculitic neuropathy. In general, seasonal influenza vaccinations are considered to be safe, however, clinicians should be aware of this rare phenomenon.

Anti-neutrophil cytoplasmic antibody (ANCA), Influenza vaccination, Vasculitis,
Allergy, Asthma and Clinical Immunology
Erasmus MC: University Medical Center Rotterdam

Eindhoven, S. (Stefanie), Levels, J. (Jolien), Huisman, M. (Margriet), de Winter, K.R. (Koos Ruizeveld), Dalm, V.A.S.H, & Alwani, R.A. (2017). MPO-ANCA associated vasculitis with mononeuritis multiplex following influenza vaccination. Allergy, Asthma and Clinical Immunology, 13(1). doi:10.1186/s13223-017-0222-9