Wang L, Zhang X, Liu YT. Agranulocytosis following injection of inactivated Japanese encephalitis vaccine (Vero cell): A case report. World J Clin Cases 2021; 9(25): 7468-7471 [PMID: 34616813 DOI: 10.12998/wjcc.v9.i25.7468]
Corresponding Author of This Article
Yan-Tao Liu, MSc, Associate Professor, Department of Pharmacy, West China Second University Hospital, Sichuan University/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, No. 20, Section 3, South Renmin Road, Chengdu 610041, Sichuan Province, China. 2287083973@qq.com
Research Domain of This Article
Immunology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 6, 2021; 9(25): 7468-7471 Published online Sep 6, 2021. doi: 10.12998/wjcc.v9.i25.7468
Agranulocytosis following injection of inactivated Japanese encephalitis vaccine (Vero cell): A case report
Li Wang, Xu Zhang, Yan-Tao Liu
Li Wang, Yan-Tao Liu, Department of Pharmacy, West China Second University Hospital, Sichuan University/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, Sichuan Province, China
Xu Zhang, Department of Pharmacy, West China Second University Hospital, Sichuan University/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, Sichuan Province, China/Department of Pharmacy, Dechang People's Hospital, Liangshan 615500, Sichuan Province, China
Author contributions: Wang L reviewed the literature and drafted the manuscript; Zhang X was responsible for the revision of the manuscript for important intellectual content; Liu YT reviewed the literature and contributed to manuscript drafting; all authors issued final approval for the version to be submitted.
Informed consent statement: Written informed consent was obtained from the patient’s parents for publication of this case and accompanying images.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Tao Liu, MSc, Associate Professor, Department of Pharmacy, West China Second University Hospital, Sichuan University/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, No. 20, Section 3, South Renmin Road, Chengdu 610041, Sichuan Province, China. 2287083973@qq.com
Received: December 25, 2020 Peer-review started: December 25, 2020 First decision: May 11, 2021 Revised: May 25, 2021 Accepted: July 16, 2021 Article in press: July 16, 2021 Published online: September 6, 2021
Abstract
BACKGROUND
Japanese encephalitis virus (JEV), a mosquito borne flavivirus, is the leading cause of viral encephalitis in Asia, in terms of frequency and severity. JEV infection is thought to confer lifelong immunity. With the near eradication of poliomyelitis, JEV is now the continent’s leading cause of childhood viral neurologic infection and disability. The most common clinical manifestation of JEV infection is acute encephalitis, and currently there is no specific antiviral therapy. Japanese Encephalitis Vaccine (JE-VC) is an effective prevention measure, including JE-VC, Live (JE-MB), and Inactivated JE-VC.
CASE SUMMARY
A 9-mo-old girl received injection of Inactivated JE-VC (Vero cell) (Liaoning Chengda, batch number 201611B17) on August 31, 2017. On that night, she developed a fever with the body temperature up to 38.5 °C, for which Ibuprofen Suspension Drops 1.25 mL was given as antipyretic treatment. On September 1, the patient developed apocleisis, and her parents noticed herpes in her oral cavity. The patient was sent to our hospital on September 3. Physical examination led to a diagnosis of herpetic stomatitis, for which Stomatitis Spray 1 puff, tid, Kangfuxin Liquid 2 mL, tid, and vitamin B2 0.5 tablet, tid, were prescribed. Routine blood tests for low fever on September 6, 2017 revealed an absolute neutrophil count (ANC) of 0.62 × 109/L, hemoglobin (Hb) of 109 g/L, and platelet count (PLT) of 308 × 1012/L, and the tests were monitored regularly thereafter. The patient was followed until July 26, 2020, when routine blood tests revealed ANC 1.72 × 109/L, Hb 138 g/L, and PLT 309 × 1012/L, indicating that the neutropenia count had normalized.
CONCLUSION
This report attempts to bring to clinical attention that Inactivated JE-VC (Vero cell) might cause prolonged granulocytopenia or even agranulocytosis.
Core Tip: So far, there has been no report of vaccine-induced neutropenia that persisted for 2 years until recovery. Japanese Encephalitis virus, a mosquito borne flavivirus, is the leading cause of viral encephalitis in Asia, in terms of frequency and severity. This report attempts to bring to clinical attention that Inactivated Japanese Encephalitis Vaccine (Vero cell) might cause prolonged neutropenia or even agranulocytosis.
