Clinical Reviews in Allergy & Immunology

, Volume 41, Issue 2, pp 163–168

Macrophagic Myofaciitis a Vaccine (alum) Autoimmune-Related Disease

  • Eitan Israeli
  • Nancy Agmon-Levin
  • Miri Blank
  • Yehuda Shoenfeld
Article

DOI: 10.1007/s12016-010-8212-4

Cite this article as:
Israeli, E., Agmon-Levin, N., Blank, M. et al. Clinic Rev Allerg Immunol (2011) 41: 163. doi:10.1007/s12016-010-8212-4

Abstract

Macrophagic myofasciitis (MMF) is an immune-mediated condition first reported in 1998. MMF is characterized by post-vaccination systemic manifestations as well as local-stereotyped and immunologically active lesion in the site of inoculation (deltoid muscle). MMF systemic symptoms included myalgias, arthralgias, marked asthenia, muscle weakness, chronic fatigue, and fever. Recently, studies demonstrated that the local lesion is due to persistence for years at site of injection of an aluminum (Al(OH)3) adjuvant commonly used in human vaccines. Time elapsed from last immunization with an Al(OH)3-containing vaccine to muscle biopsy range from 3 months to 8 years; in rare cases, MMF may be diagnosed even 10 years post-vaccination. The discrepancy between the wide applications of aluminum hydroxide-containing vaccines and the very limited number of MMF cases reported may be resolved by observations suggesting that aluminum-containing vaccinations may trigger MMF in genetically susceptible subjects carrying the HLA-DRB1*01. Thus, MMF may be defined as an emerging novel condition that may be triggered by exposure to alum-containing vaccines, in patients with a specific genetic background, and this temporal association may be exhibited from a few months up to 10 years.

Keywords

Macrophagic myofaciitisVaccinesAluminumAutoimmunityAdjuvant

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Eitan Israeli
    • 1
  • Nancy Agmon-Levin
    • 1
    • 2
  • Miri Blank
    • 1
  • Yehuda Shoenfeld
    • 1
    • 2
    • 3
  1. 1.Center for Autoimmune DiseasesSheba Medical CenterTel-HashomerIsrael
  2. 2.Department of Medicine ‘B’ and Center for Autoimmune DiseasesChaim Sheba Medical CenterTel-HashomerIsrael
  3. 3.Sackler Faculty of Medicine, Incumbent of the Laura Schwarz-Kip Chair for Research of Autoimmune DiseasesTel-Aviv UniversityTel-AvivIsrael