A Case of Reactive Arthritis Developed After Tetanus Vaccine

Abstract

Objective: Reactive arthritis (ReA) is a kind of spondyloarthropathy. Some ReA can develop after vaccinations. In this report, we presented a case with ReA after tetanus vaccination.Case: 29-year-old woman with right ankle swelling was applied to outpatient of physical medicine and rehabilitation department two days after tetanus vaccination. Acute phase reactants were elevated. Non-steroidal anti-inflammatory drugs and steroids were given for arthritis. She was followed for six months. Results: Drug combination was continued for two months.After the third week of steroid therapy, the ankle of patient was normal. And steroid dose was reduced and stopped at the end of the two months. There was no reccurence at the end of six months. Conclusion:ReA due to tetanus vaccination is a rare event. Patients must be informed and must be followed for the developement of ReA after tetanus vaccination.

Neglected reactive arthritis complicated by bilateral hip and temporomandibular joints ankylosis after a suspected tetanus infection: a case report

“…As the vaccine itself is considered an imitation of infection to stimulate the immune response [17], we proposed that the reported mechanism behind the development of ReA after tetanus vaccination [5][6][7][8] is the cause of the joint affection in the current case report. Although the exact mechanism by which vaccination trigger ReA is not fully understood [5], however, some theories were postulated to explain this reaction, as the vaccine itself may trigger reactive events in genetically susceptible individuals as it may resemble a host antigen leading to the activation of an autoimmune response which may be enhanced by HLAB27 [6]; however, the expression of HLAB27 is positive in about 75% of the cases [18]; the rest of the cases may be negative as the finding in the current case report.…”

“…Reactive arthritis (ReA) is a rare non-purulent joint inflammation condition with unknown exact etiology [3]; however, it was reported to be associated with various types of infection (upper respiratory, gastrointestinal, and urogenital) [4]. Development of ReA had been reported after administration of various vaccinations, including influenza, rabies, bacillus Calmette-Guerin (BCG), and tetanus vaccines in few case reports [5][6][7][8]; however, to the best of our knowledge, it had not been reported after a tetanus infection.…”