Autoimmune hemolytic anemia following XXXX -adjuvanted @entity683 vaccine administration: a report of two cases.

@entity1 @entity24288 @entity1156 @entity1395 @entity683 @entity5506 @entity6250 @entity792 @entity490 @entity4841 @entity590 @entity288
OBJECTIVE: To describe 2 cases of @entity5506 ( @entity5506 ) following the administration of @entity1156 -adjuvanted @entity683 vaccine. CASE SUMMARY: An 83-year-old white @entity1 developed persistent @entity590 , @entity4841 , and @entity6250 about 2 days after receiving @entity683 vaccine. Clinical signs and laboratory evaluations suggested @entity5506 . The @entity1 was treated with high-dose corticosteroids and immunoglobulins, and her clinical condition improved. A 74-year-old white @entity1 developed severe @entity490 and @entity1395 3 days after the administration of @entity683 vaccine. Clinical signs and laboratory evaluations disclosed @entity5506 . She was treated with @entity288 , rehydration, and blood transfusion; however, she died about 48 hours after hospitalization. DISCUSSION: @entity5506 has been rarely described following @entity683 vaccine administration. In the cases described here, the causal relationship between @entity683 vaccination and the occurrence of @entity5506 , assessed by means of World Health Organization criteria, was scored as probable. It has been proposed that the mechanism whereby vaccines induce @entity792 can be molecular mimicry, although a possible role of other vaccine constituents, with particular regard for adjuvants, such as @entity1156 , can not be excluded. @entity24288 , a constituent of @entity1156 , has been suggested as a causative agent of autoimmune reactions. However, it is not clear how and under what conditions squalene can cause immune responses. CONCLUSIONS: Influenza vaccination may rarely trigger severe @entity5506 , shortly after vaccine administration. A mechanism of molecular mimicry is probably involved in the development of these reactions, although the possible role of adjuvants can not be excluded. @entity1 should be instructed to report signs and symptoms of @entity792 occurring in the first weeks after administration of @entity683 vaccine.
