Rabies post-exposure prophylaxis for a male with severe Henoch Schönlein purpura following rabies vaccination

• Published in: Human vaccines & immunotherapeutics Vol. 14; no. 11; pp. 2666 - 3
• Main Authors: Zhu, Zheng-Gang, Zheng, Yi, Lu, Sha, Hu, Quan, Fang, Yuan
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 02.11.2018; Taylor & Francis Group
• Subjects: Adult; allergic reaction; Animals; Anti-Allergic Agents - therapeutic use; Antibodies, Viral - blood; Bites and Stings - virology; Case Report; Dogs; henoch schönlein purpura (hsp); Humans; Male; neutralizing antibody (rvna) titer; Post-Exposure Prophylaxis; purified vero cell rabies vaccine (pvrv); Purpura, Schoenlein-Henoch - blood; Purpura, Schoenlein-Henoch - drug therapy; Purpura, Schoenlein-Henoch - etiology; Rabies - prevention & control; Rabies - transmission; Rabies Vaccines - administration & dosage; Rabies Vaccines - adverse effects; Rabies virus - immunology; rabies virus neutralizing antibody (rvna); allergic reaction; purified vero cell rabies vaccine (PVRV); Henoch Schönlein purpura (HSP); rabies virus neutralizing antibody (RVNA); neutralizing antibody (RVNA) titer
• ISSN: 2164-5515; 2164-554X
• DOI: 10.1080/21645515.2018.1486354

Henoch Schönlein purpura (HSP) following vaccine administration has been described in case reports and in a small number of observational studies. We herein reported a case of HSP occurring in an otherwise healthy 37-year-old male after immunization with lyophilized purified vero cell rabies vaccine (PVRV). After the anti-allergy therapy with hormone, the purpuric lesions gradually disappeared. After evaluating, another PVRV with different dose (0.5 ml), strains, excipient and without residues was chosen for the new anti-rabies immunization program, and the patient has had no recurrence of allergic symptoms. Although significant lower than the levels of normal 20-50 year population at day 21, the neutralizing antibody (RVNA) titers of this boy showed adequate protective antibody (3.23 vs 7.15 IU/ml). This case report emphasizes the importance that clinicians should be aware of HSP as a potential adverse event associated with PVRV vaccination. And adverse events (AEs) after immunization should be carefully treated, changing immunization program in time is necessary. While enrolling a new anti-rabies immunization program, the properties of different rabies vaccines taking with special emphasis on strains, excipient and residues is imperative before vaccination so that an appropriate immune program can be managed to be initiated.