Patients who develop inflammatory polyarthritis (IP) after immunization are clinically indistinguishable from other patients with IP |
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Authors: | Harrison BJ; Thomson W; Pepper L; Ollier WE; Chakravarty K; Barrett EM; Silman AJ; Symmons DP |
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Institution: | ARC Epidemiology Research Unit, Manchester. |
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Abstract: | Musculoskeletal symptoms may occur following various types of immunization,
and it has also been suggested that, like infection, immunization may act
as a trigger for rheumatoid arthritis (RA). A total of 48 of 898 (5.3%)
patients with early inflammatory polyarthritis (IP) referred to the Norfolk
Arthritis Register reported an immunization in the 6 weeks prior to symptom
onset. There were no important clinical or demographic differences between
the 48 immunized patients and 185 consecutive patients who did not report
prior immunization. In addition, the frequencies of HLA-DRB1*01. *04 and
the shared epitope in 33 of the immunized patients were similar to those in
the 185 non-immunized patients and to those in 136 healthy controls.
Further results from a case-control study suggest that the rate of
immunization is higher amongst cases (5.5%) than age- and sex-matched
controls (2.8%). In a small number of susceptible individuals, immunization
may thus act as a trigger for RA.
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