Atypical Lymph-Node Hyperplasia after Administration of Attenuated, Live Measles Vaccine
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Cited by 8 publications
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WITH the development of a safe, effective measles vaccine, it has recently become an accepted and recommended procedure to immunize susceptible children against this disease which can cause significant mortality and morbidity. The live, attenuated measles virus vaccines, derived from the Edmonston B strain and the Schwarz strain, are the vaccines of choice for routine immunization.1,2 These vaccines require only one injection and seemingly confer a lifetime of immunity.3 No serious reaction from the use of these vaccines has been reported, but convulsions secondary to vaccine-induced fever may occur.4 This report describes two unusual complications which followed vaccination with live, attenuated measles virus. Report of Cases CASE 1.\p=m-\A12-month-old white girl received a subcutaneous, live virus attenuated measles vaccine injection (Edmonston strain) with \ g = g \ \ x = r e q -\ globulin (0.01 cc/lb). Seven days later she became fussy and developed a fever. On the eighth postvaccination day, a hive-like rash developed on the trunk, and diphenhydramine was prescribed. On the tenth postvaccination day, petechiae developed and the child was ad¬ mitted to the hospital. Physical examination revealed a toxic, well-developed, well-nour¬ ished, infant. She had a fever of 102 F (38.9 C), pulse, 108; and her respirations were 36. The face, neck (Figure, A), and torso were covered with small, nonraised petechiae. Mild periorbital edema was present and there was evidence of a fading, serpiginous, hive-like rash over the back. The rest of the examination results were normal.Her white blood cell count (WBC) was 7,100 with 66 lymphocytes (some atypical), 18 neutrophils, 14 bands, two monocytes, and 60,000 platelets/cu mm. The hematocrit was 30% and moderate hypochromia of the erythrocytes was evident. A throat culture grew normal flora.Results of urinalysis and the spinal fluid exam¬ ination were normal.Because of toxicity, fever, and petechiae, a diagnosis of meningococcemia was considered. Penicillin in large doses was started intrave¬ nously after the blood, spinal fluid, and petechial aspirate cultures were obtained. A gram stain smear of the petechial aspirate failed to demonstrate any inflammatory exúdate or bac¬ teria. Repeat platelet count on the following day was also 60,000. Thirty-six hours after ad¬ mission, the child's fever lysed without further elevations and she began to improve clinically. Antibiotic and intravenous therapy were then stopped since all the cultures were negative for bacterial growth. A bone marrow examination on the 11th postvaccine day revealed hyperpla¬ sia of the megakaryocytic series (Figure, B). Some of the megakaryocytes (24%) were form¬ ing some platelets but 76% of the cells in the series, including megakaryoblasts, promegakaryocytes, and intermediate forms5 showed no platelet formation (Figure, C and D). The marrow differential was essentially within nor¬ mal limits except for eosinophilic hyperplasia, with 7% eosinophilic myelocytes and 7% eosinophiles. Fat to marrow ratio was app...
WITH the development of a safe, effective measles vaccine, it has recently become an accepted and recommended procedure to immunize susceptible children against this disease which can cause significant mortality and morbidity. The live, attenuated measles virus vaccines, derived from the Edmonston B strain and the Schwarz strain, are the vaccines of choice for routine immunization.1,2 These vaccines require only one injection and seemingly confer a lifetime of immunity.3 No serious reaction from the use of these vaccines has been reported, but convulsions secondary to vaccine-induced fever may occur.4 This report describes two unusual complications which followed vaccination with live, attenuated measles virus. Report of Cases CASE 1.\p=m-\A12-month-old white girl received a subcutaneous, live virus attenuated measles vaccine injection (Edmonston strain) with \ g = g \ \ x = r e q -\ globulin (0.01 cc/lb). Seven days later she became fussy and developed a fever. On the eighth postvaccination day, a hive-like rash developed on the trunk, and diphenhydramine was prescribed. On the tenth postvaccination day, petechiae developed and the child was ad¬ mitted to the hospital. Physical examination revealed a toxic, well-developed, well-nour¬ ished, infant. She had a fever of 102 F (38.9 C), pulse, 108; and her respirations were 36. The face, neck (Figure, A), and torso were covered with small, nonraised petechiae. Mild periorbital edema was present and there was evidence of a fading, serpiginous, hive-like rash over the back. The rest of the examination results were normal.Her white blood cell count (WBC) was 7,100 with 66 lymphocytes (some atypical), 18 neutrophils, 14 bands, two monocytes, and 60,000 platelets/cu mm. The hematocrit was 30% and moderate hypochromia of the erythrocytes was evident. A throat culture grew normal flora.Results of urinalysis and the spinal fluid exam¬ ination were normal.Because of toxicity, fever, and petechiae, a diagnosis of meningococcemia was considered. Penicillin in large doses was started intrave¬ nously after the blood, spinal fluid, and petechial aspirate cultures were obtained. A gram stain smear of the petechial aspirate failed to demonstrate any inflammatory exúdate or bac¬ teria. Repeat platelet count on the following day was also 60,000. Thirty-six hours after ad¬ mission, the child's fever lysed without further elevations and she began to improve clinically. Antibiotic and intravenous therapy were then stopped since all the cultures were negative for bacterial growth. A bone marrow examination on the 11th postvaccine day revealed hyperpla¬ sia of the megakaryocytic series (Figure, B). Some of the megakaryocytes (24%) were form¬ ing some platelets but 76% of the cells in the series, including megakaryoblasts, promegakaryocytes, and intermediate forms5 showed no platelet formation (Figure, C and D). The marrow differential was essentially within nor¬ mal limits except for eosinophilic hyperplasia, with 7% eosinophilic myelocytes and 7% eosinophiles. Fat to marrow ratio was app...
This study was carried out to evaluate the antitumor effect of live attenuated measles virus Schwarz (MV) vaccine strain on tumor cell lines in vitro. Live attenuated measles virus Schwarz vaccine strain was obtained from Aventis Pasteur, France. Live attenuated measles virus Schwarz strain was propagated on Vero, human Rhabdomyosarcoma (RD) and human Glioblastoma-Multiform (GBM) cell lines which were supplied by Iraqi Center for Cancer and Medical Genetic Researches (ICCMGR). Results revealed that cell fusion occurred after 24 h of infection. The infected confluent monolayer appeared to be covered with syncytia with granulation and vaculation of cells after 72 to 120 h. Moreover, the formation of large round empty plaque spaces was observed in infected cells. Results of oncolytic cytopathic effect showed that after 120 h of exposure alterations in morphology of Vero, RD and GBM cells. Cells were rounded, shrink, clustered cells and large empty space with cell debris as a result of cell lysis and death. Haemadsorption effect of MV was studied and result recorded that all cell lines infected with virus have the ability for haemadsorption human red blood cells after 72 h of infection. While uninfected cells gave negative results. Detection of MV H protein by monoclonal antibodies in infected cells of all cell lines by immunocytochemistry assay gave positive results (brown color) in cytoplasm of infected cells. Cell viability was measured after 72 h of infection by MTT assay. Results showed a significant cytotoxic effect for measles virus (P ≤0.05) on growth of RD and GBM cell lines at the first dilution and the second one after 72 h of infection. When the dilution increases, there was a significant decline in the inhibitory effect with a significant cytotoxic effect as compared with the control. Also, concentrated inoculums of measles virus showed a significant cytotoxic effect when compared with the control.
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