HLA haplotype in a patient with systemic lupus erythematosus triggered by hepatitis B vaccine

Aim: Find an association be- tween hepatitis B vaccine-related systemic lupus erythematosus and HLA. Material: A 27-year-old woman who developed a lupus nephritis after the administration of hepatitis B vaccine. Methods: We studied HLA antigen expression on lymphocytes and genomic haplotype. Class I-II HLA antigen typing was performed by the microlymphocytotoxicity test with the standard NIH method, and Class I-II HLA allele typing by polymerase chain reaction, using single-strand oligonucleotide dot-blot kits. Results: The serological haplo- type was HLA A24/25, B18 (Bw6)/–, C–/–, DQ7/–, DR11(5)/52. The genomic haplotype was A*2403/2504, B*1825/1825, C*1207/ 1207, DRB1*1102/1132, DRB3*0202/0202, DQA1*0505/0505, DQB1*0301/0301. Then we sought for analogies with haplotypes known to be related to other systemic AID. Since we have found HLA alleles typical both of systemic lupus erythematosus and Sjogren’s syndrome, the persistence of ENA-SSA posi- tivity was highly suspicious for a possible overlap syndrome. Conclusions: Hepatitis B vaccine can potentially trigger both the onset or the exacerbations of several autoimmune disorders, including systemic lupus erythe- matosus, by reduced immune complex clear- ance or molecular mimicry. This study repre- sents the first report on the association be- tween hepatitis B vaccine related systemic lupus erythematosus and HLA. Probably au- toimmune reactions triggered by vaccines oc- cur only in predisposed subjects, in which an- tigen presentation influenced by HLA haplo- types leads to the autoimmune cascade. More studies are needed to corroborate our hypoth- esis. They could disclose new pathways in the field of prevention.