Arthritis following combined vaccine against diphtheria, polyomyelitis, and tetanus toxoid

J.F. Maillefert¹, I. Tonolli-Serabian², A. Cherasse¹, A.-L. Demoux², C. Tavernier¹, L. Piroth³

¹Department of Rheumatology and ³Department of Infectious Diseases, Dijon University Hospital; ²Department of Emergency, Marseille University Hospital, France.

ABSTRACT
We describe 2 cases of arthritis following immunization against diphtheria, poliomyelitis and tetanus toxoid. One patient developed monoarthritis of the knee after immunization, that regressed following synovectomy. Five years later, the arthritis recurred after a booster vaccine injection. One day after immunization, another patient developed arthritis of the ankle that persisted for 3 days.
It is difficult to know whether there is a coincidental or a causal relation between immunization and arthritis. Although our cases suggest that immunization against diphtheria, poliomyelitis and tetanus toxoid may cause arthritis, additional cases must be reported before studies aimed at confirming this possibility are considered.

Key words
Immunization, adverse effects, arthritis.

Please address correspondance and reprint requests to: Jean Francis Maillefert, MD, Service de Rhumatologie, Hôpital Général, 3 rue du Fb Raines, 21000 Dijon, France. 
E-mail: jmaillefert@chu-dijon.fr

Clin Exp Rheumatol 2000; 18: 255-256.
© Copyright Clinical and Experimental Rheumatology 2000.