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Atypical measles syndrome: pathologic and serologic findings
Pediatrics
|August 1, 1982
Summary
Previous measles vaccination with killed vaccine led to unusual skin and lung symptoms in adolescents. This suggests the vaccine failed to induce crucial antibodies against measles virus cell-to-cell spread.
Area of Science:
- Immunology
- Virology
- Dermatology
Background:
- Measles vaccination is critical for public health.
- Previous studies explored inactivated measles vaccines.
- The immune response to killed measles vaccines requires further investigation.
Purpose of the Study:
- To describe the clinical, serologic, and histopathologic features of measles in adolescents vaccinated with killed measles vaccine.
- To evaluate the immune response induced by killed measles vaccine.
- To understand the pathogenesis of measles in vaccinees.
Main Methods:
- Clinical case series of 17 adolescents with measles post-killed vaccine.
- Serologic analysis using immunoprecipitation of measles virus antigens.
- Histopathologic examination of skin biopsies.
Main Results:
- All patients exhibited peripheral dermatitis and 15 had pulmonary infiltrates.
- Serologic studies showed a lack of antibody to hemolysin (F) antigen in 5/6 cases, but antibody to hemagglutinin antigen was present.
- Skin biopsies revealed Arthus and delayed hypersensitivity reactions, not typical measles histology, with measles virions in dermal vessels.
Conclusions:
- Killed measles vaccine inadequately induces antibody to the hemolysin (F) antigen, crucial for preventing paramyxovirus cell-to-cell spread.
- The vaccine elicits hemagglutinin antibody and hypersensitivity, leading to atypical dermatopathology during wild virus infection.
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