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DOI: 10.1055/s-0042-109871
Yellow fever vaccination during treatment with infliximab in a patient with ulcerative colitis: A case report
Gelbfieberimpfung unter Infliximab bei einem Patienten mit Colitis ulcerosa: ein FallberichtPublication History
06 March 2016
01 June 2016
Publication Date:
09 September 2016 (online)
![](https://www.thieme-connect.de/media/zfg/201609/lookinside/thumbnails/zfg-0022_10-1055-s-0042-109871-1.jpg)
Abstract
We report the case of a 59-year-old patient who accidentally underwent live vaccination against yellow fever during continuous treatment with the TNF-α-antibody (AB) infliximab for ulcerative colitis. The clinical course showed fever of short duration and elevation of liver enzymes without further clinical complications. Yellow fever viremia was not detectable and protective antibodies were developed. A primary vaccination against yellow fever under infliximab has not been reported in the literature before, although vaccination is an important topic in IBD. Live vaccinations, like Stamaril® against yellow fever, are contraindicated during TNF-α-AB treatment. Treatment regimens containing TNF-α-AB are of growing importance, not only in gastroenterology, but also in rheumatology and dermatology. We discuss this topic by presenting our case and reviewing the current literature.
Zusammenfassung
Wir berichten über einen 59-jährigen Patienten mit Colitis ulcerosa, der während einer Therapie mit dem TNF-α-Antikörper (AK) Infliximab gegen Gelbfieber geimpft wurde. Im klinischen Verlauf entwickelte der Patient Fieber und erhöhte Leberwerte ohne weitere Komplikationen. Virämie durch das Gelbfieber-Virus war nicht nachweisbar und der Patient entwickelte schützende Antikörper gegen Gelbfieber.
Eine erstmalige Impfung gegen Gelbfieber unter Infliximab wurde bisher nicht beschrieben, obwohl Impfungen ein wichtiges Thema sind, nicht nur in der Therapie chronisch entzündlicher Darmerkrankungen. Lebendimpfungen, wie Stamaril® gegen Gelbfieber, sind kontraindiziert während einer TNF-α-AK-Therapie. Therapieregime mit TNF-α-AK sind von großer Bedeutung, nicht nur in der Gastroenterologie, sondern auch in der Rheumatologie und Dermatologie. Wir stellen unseren Fall und die aktuelle Literatur zum Thema vor.
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References
- 1 Ott C, Takses A, Obermeier F et al. How fast up the ladder? Factors associated with immunosuppressive or anti-TNF therapies in IBD patients at early stages: results from a population-based. Int J Colorectal Dis 2014; 29: 1329-1338
- 2 Dignass A, Preiss JC, Aust DE et al. Updated German guideline on diagnosis and treatment of ulcerative colitis, 2011. Zeitschrift fur Gastroenterologie 2011; 49: 1276-1341
- 3 Dignass A, Lindsay JO, Sturm A et al. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 2: current management. J Crohns Colitis 2012; 6: 991-1030
- 4 Stallmach A, Nickel L, Lehmann T et al. Parameters of a severe disease course in ulcerative colitis. World J Gastroenterol 2014; 20: 12574-12580
- 5 Biologic drugs set to top 2012 sales. Nat Med 2012; 18: 636
- 6 Stallmach A, Hagel S, Bruns T. Adverse effects of biologics used for treating IBD. Best Pract Res Clin Gastroenterol 2010; 24: 167-182
- 7 Lichtenstein GR, Feagan BG, Cohen RD et al. Serious infections and mortality in association with therapies for Crohn's disease: TREAT registry. Clin Gastroenterol Hepatol 2006; 4: 621-630
- 8 Walsh AJ, Weltman M, Burger D et al. Implementing guidelines on the prevention of opportunistic infections in inflammatory bowel disease. J Crohns Colitis 2013; 7: e449-e456
- 9 Monath TP, Cetron MS. Prevention of yellow fever in persons traveling to the tropics. Clin Infect Dis 2002; 34: 1369-1378
- 10 WHO. Yellow fever. Fact sheet. http://www.who.int/mediacentre/factsheets/fs100/en/
- 11 Mitteilung der Ständigen Impfkommission (STIKO) am Robert Koch-Institut: Hinweise zu Impfungen für Patienten mit Immundefizienz. In: (RKI) RK-I ed; 2005
- 12 Rahier JF, Magro F, Abreu C et al. Second European evidence-based consensus on the prevention, diagnosis and management of opportunistic infections in inflammatory bowel disease. J Crohns Colitis 2014; 8: 443-468
- 13 Pfister M, Kursteiner O, Hilfiker H et al. Immunogenicity and safety of BERNA-YF compared with two other 17D yellow fever vaccines in a phase 3 clinical trial. Am J Trop Med Hyg 2005; 72: 339-346
- 14 Rahier JF, Moreels T, De Munter P et al. Prevention of opportunistic infections in patients with inflammatory bowel disease and implications of the ECCO consensus in Belgium. Acta Gastroenterol Belg 2010; 73: 41-45
- 15 Mitteilung der Ständigen Impfkommission am Robert Koch-Institut (RKI) Empfehlungen der Ständigen Impfkommission (STIKO) am Robert Koch-Institut/Stand: August 2014. Epidemiologisches Bulletin 25. August 2014 Nr. 34.
- 16 Rubin LG, Levin MJ, Ljungman P et al. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis 2014; 58: 309-318
- 17 Long MD, Gulati A, Wohl D et al. Immunizations in pediatric and adult patients with inflammatory bowel disease: a practical case-based approach. Inflamm Bowel Dis 2015; 21: 1993-2003
- 18 Belmusto-Worn VE, Sanchez JL, McCarthy K et al. Randomized, double-blind, phase III, pivotal field trial of the comparative immunogenicity, safety, and tolerability of two yellow fever 17D vaccines (Arilvax and YF-VAX) in healthy infants and children in Peru. Am J Trop Med Hyg 2005; 72: 189-197
- 19 Kelso JM, Mootrey GT, Tsai TF. Anaphylaxis from yellow fever vaccine. J Allergy Clin Immunol 1999; 103: 698-701
- 20 Martin M, Tsai TF, Cropp B et al. Fever and multisystem organ failure associated with 17D-204 yellow fever vaccination: a report of four cases. Lancet 2001; 358: 98-104
- 21 Nash ER, Brand M, Chalkias S. Yellow fever vaccination of a primary vaccinee during adalimumab therapy. J Travel Med 2015; 22: 279-281
- 22 Scheinberg M, Guedes-Barbosa LS, Mangueira C et al. Yellow fever revaccination during infliximab therapy. Arthritis Care Res (Hoboken) 2010; 62: 896-898
- 23 Azevedo LS, Lasmar EP, Contieri FL et al. Yellow fever vaccination in organ transplanted patients: is it safe? A multicenter study. Transpl Infect Dis 2012; 14: 237-241
- 24 Oliveira ACV, Mota LMH, Santos-Neto LL et al. Seroconversion in patients with rheumatic diseases treated with immunomodulators or immunosuppressants, who were inadvertently revaccinated against yellow fever. Arthritis Rheumatol 2015; 67: 582-583
- 25 Soonawala D, van Eggermond AM, Fidder H et al. Pretravel preparation and travel-related morbidity in patients with inflammatory bowel disease. Inflamm Bowel Dis 2012; 18: 2079-2085