Reactions 1456 - 15 Jun 2013

Yellow fever vaccine

Elevated liver enzymes and skin reaction: casereport

A 55-year-old man developed elevated liver enzymes and askin reaction after receiving live attenuated yellow fevervaccine.

The man, who had undergone a kidney transplant 19 yearsearlier, received yellow fever vaccine [dose and route notstated]. Shortly afterwards, he realised the risks associatedwith the vaccination and contacted his nephrologist. His liverenzymes were monitored. Eleven days postvaccination, hisAST and ALT levels were 60 units/mL and 53 units/mL,respectively.

The man received immune globulin to reduce the risk ofyellow fever-associated viscerotropic disease. His AST and ALTlevels were normal on postvaccination day 18; however, histotal bilirubin level was elevated at 2.4 units/mL on day 25. Onday 26, he reported what may have been an eczematous orurticarial reaction on his face, the symptoms resolved within5 days. His total bilirubin, AST and ALT levels were all normalon day 47. At follow-up 8 months later, he had not experiencedany long-term adverse events.

Author comment: "These results suggest that [intravenousimmune globulin] could be administered as a precautionagainst potential [yellow fever-associated viscerotropicdisease] or other [yellow fever virus] vaccine-associatedadverse events."Slifka MK, et al. Antiviral immune response after live yellow fever vaccination ofa kidney transplant recipient treated with IVIG. Transplantation 95: e59-e61, No.9, 15 May 2013. Available from: URL: http://dx.doi.org/10.1097/TP.0b013e31828c6d9e - USA 803088544

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Reactions 15 Jun 2013 No. 14560114-9954/10/1456-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved