Post-vaccination aluminium granulomas in children. 2022

Line Ravndal, and Elisabet Bergfors, and Mehdi Behzadi, and Bjørn Barstad, and Bjarte Steinkjer, and Svein Kjosavik

Persistent itching subcutaneous granulomas related to aluminium-containing vaccines are poorly recognised in health care. They are often associated with aluminium hypersensitivity. An intensely itching subcutaneous nodule appeared on the left thigh of a 17-month-old girl at the injection site for an aluminium adsorbed diphtheria-tetanus-pertussis-polio-HiB vaccine given at 3, 5 and 12 months. Ultrasound suggested a vascular malformation among other differential diagnoses. An MR investigation under general anaesthesia was planned, but the diagnosis was confirmed prior to this by a positive epicutaneous test with aluminium. Despite a typical history of an itchy vaccination granuloma, the child underwent a thorough hospital workup to rule out malignancy. The diagnosis was delayed for two years. Vaccination granulomas have a good prognosis but can persist for many years. It is important to recognise the condition early in primary health care to avoid unnecessary anxiety and investigations.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D011537 Pruritus An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. Itching,Pruritis
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D005260 Female Females
D006099 Granuloma A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents. Granulomas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000535 Aluminum A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. Aluminium,Aluminium-27,Aluminum-27,Aluminium 27,Aluminum 27
D014611 Vaccination Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. Immunization, Active,Active Immunization,Active Immunizations,Immunizations, Active,Vaccinations
D015721 Diphtheria-Tetanus-Pertussis Vaccine A vaccine consisting of DIPHTHERIA TOXOID; TETANUS TOXOID; and whole-cell PERTUSSIS VACCINE. The vaccine protects against diphtheria, tetanus, and whooping cough. DPT Vaccine,DTP Vaccine,DTwP Vaccine,Diphtheria-Pertussis-Tetanus Vaccine,Di-Te-Per Vaccine,Di Te Per Vaccine,Diphtheria Pertussis Tetanus Vaccine,Diphtheria Tetanus Pertussis Vaccine,Vaccine, DPT,Vaccine, DTP,Vaccine, DTwP,Vaccine, Di-Te-Per,Vaccine, Diphtheria-Pertussis-Tetanus,Vaccine, Diphtheria-Tetanus-Pertussis

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