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.

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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., & Alwani, R. (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