Metabolic Crisis Induced By Vaccination in Seven Chinese Patients

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Acute Metabolic Crisis Induced By Vaccination in Seven Chinese

Patients

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Yanling Yang MD, a, , , Sayami Sujan MDa, Fang Sun MDa, Yuehua Zhang

MDa, Yuwu Jiang MDa, Jinqing Song MSa, Jiong Qin MDa and Xiru Wu MDa

aDepartment of Pediatrics, Peking University First Hospital, Beijing,

China.

Received 11 July 2005;

accepted 19 December 2005.

Available online 25 July 2006.

Seven Chinese patients (5 males and 2 females) with vaccination-

induced acute metabolic crisis were reported. Only one male with 21-

hydroxylase deficiency had been diagnosed before vaccination. In the

remaining six patients, the preexisting diagnoses were not confirmed

before the vaccination. Acute metabolic crisis occurred in seven

patients between 3 and 12 hours after the administration of Japanese

encephalitis, diphtheria, and tetanus toxoids and acellular

pertussis, hepatitis B, or measles vaccines. Patients 1 and 2

displayed acute adrenal insufficiencies at the ages of 5 years and 3

months, respectively. Patient 3 had presented with mild motor

retardation previously. Patients 4 to 7 were previously healthy, but

suffered from fever, seizures, coma, acidosis, and hypoglycemia after

being vaccinated. Glutaric aciduria type 1 was evident in case 4.

Leigh syndromes were present in Patients 5, 6, and 7. They all died

from respiratory failure before 2 years of age. Symmetric foci,

cystic cavitations with neuronal loss, and vascular proliferation

were observed by postmortem examination. Among the seven patients,

although the vaccines were not the primary cause of the acute

metabolic crisis, the severe acute episodes occurred coincidentally.