Post-vaccination aluminium granulomas in children.

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

Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke 2022 Mar 01

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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.

Citation

Line Ravndal, Elisabet Bergfors, Mehdi Behzadi, Bjørn Barstad, Bjarte Steinkjer, Svein Kjosavik. Post-vaccination aluminium granulomas in children. Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke. 2022 Mar 01;142(4)