Vaccine-associated measles in a patient treated with natalizumab: a case report

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License: CC BY 4.0
Serval ID
serval:BIB_DDD0AF3D357E
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Vaccine-associated measles in a patient treated with natalizumab: a case report
Journal
BMC Infectious Diseases
Author(s)
Miauton Alix, Tan Rainer, Pantazou Vasiliki, Du Pasquier Renaud, Genton Blaise
ISSN
1471-2334
ISSN-L
1471-2334
Publication state
Published
Issued date
12/2020
Peer-reviewed
Oui
Volume
20
Number
1
Pages
753
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Safety of live vaccines in patients treated with immunosuppressive therapies is not well known, resulting in contradictory vaccination recommendations. We describe here the first case of vaccine-associated measles in a patient on natalizumab treatment.
A young female patient with relapsing-remitting multiple sclerosis on natalizumab treatment received the live attenuated measles, mumps, and rubella vaccine in preparation for a change in her treatment in favour of fingolimod, with established immunosuppressive qualities. Seven days after receiving the vaccine, our patient experienced diffuse muscle pain, fatigue, and thereafter developed a fever and then an erythematous maculopapular rash, compatible with vaccine associated measles. This was later confirmed by a positive measles RT-PCR throat swab. The patient's symptoms resolved without any sequelae.
In this case report we review the immunosuppressive qualities of natalizumab and the evidence in favour and against live vaccines in patients on this treatment. Our findings reveal the insufficient understanding of the immunosuppressive effects of new immunomodulators, and thus of the safety of live vaccines in patients on such medications. While this case triggers precaution, there is insufficient evidence to conclude that natalizumab treatment could favor the onset of vaccine-associated measles.
Keywords
Infectious Diseases
Pubmed
Web of science
Open Access
Yes
Create date
31/10/2020 15:12
Last modification date
30/04/2021 7:15
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