Adult-onset Still’s disease preceded by influenza vaccination: Coincidence or true association?

Kanon Jatuworapruk

Division of Rheumatology, Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand

Abstract

Background: Influenza vaccine has rarely been associated with the occurrence of systemic inflammatory diseases.
Objective: To present a case of adult-onset Still’s disease (AOSD) following influenza vaccination, and subsequently explore the possible association between AOSD and influenza vaccination, as well as implications for clinical practice.
Methods: Case report.
Results: We report a case of 20-year-old woman who developed typical AOSD, characterized by spiking fever, arthritis and salmon-pink rash, one week after influenza vaccination. She responded well to systemic corticosteroids therapy. This is the first case report of influenza vaccination-associated AOSD from Thailand.
Conclusion: Influenza vaccination may be a trigger of AOSD but more data are needed to confirm the association. History of recent vaccination should be explored in patients suspected of having systemic inflammatory diseases including AOSD.
Key words: adult-onset Still’s disease, influenza vaccination, fever of unknown origin, arthritis, pneumonitis