RT Journal Article
SR Electronic
T1 Influenza vaccine-induced ILD
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3807
VO 42
IS Suppl 57
A1 Piero Balbo
A1 Filippo Patrucco
A1 Andrea Lombi
A1 Roberta Nicali
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P3807.abstract
AB A 83-yr-old male was evaluated for normocapnic respiratory failure, fever and bilateral ground-glass pulmonary opacities on CT. He was affected by Chronic Lymphocytic Leukaemia (CLL) diagnosed in 2011 without any other lung diseases. No newdrugs were introduced recently. About 2 weeks before the onset of symptoms hereceived inactivated influenza virus vaccine.Bronchoalveolar lavage (BAL) performed during hospitalization revealed 58% macrophages, 40% lymphocytes and 2% eosinophils. BAL cultures for bacteria, mycobacteria, viruses and fungi were negative. The Transbronchial Lung Biopsy (TBLB) specimens showed lymphocytic interstitial inflammation with mildfibrosis. No aspects compatible with infection or malignancy was noted.Blood cultures and autoimmunity screening panelwere negative. Based on these findingswe arguedthe possibility of an interstitial lung disease(ILD)triggered by the vaccine. He started oral prednisone 25 mg/day with marked improvement of symptoms and gas exchanges. The steroid was tapered over 1 month with normalization of clinical and radiological features.Influenza vaccine-induced ILD is a rare complication. A recent review reveals that there isn't a prevalence for gender, type of vaccine administrered, time of onset of sympthoms (Watanabe S. Eur Respir J 2013;41(2):474-7). CT scans revealed bilateral ground-glass opacities and/or patchy infiltration; interstitial and alveolar lymphocytic infiltratation were demonstrated by BAL and TBLB.Definitive conclusions to explain the ILD tissue damage can't be drawn due to the small number of cases (Matsuno O. Respir Res 2012;13:39). There isn't an univocal diagnostic approach but we suggest to consider this condition excluding other potential causes after BAL and/or TBLB.