Aluminum granuloma in a child secondary to DTaP-IPV vaccination: A case report

Carter K. Haag, Elizabeth Dacey, Nick Hamilton, Kevin P. White

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Reports detailing the acute formation of aluminum granulomas, which can cause persistent, intensely pruritic nodules secondary to the administration of aluminum-containing vaccines, are infrequently described in medical literature. To our knowledge, this is the first report describing the development of an aluminum granuloma causing a persistent, pruritic nodule at the injection site following the administration of the DTaP-IPV vaccine. We present the case of a 6-year-old girl who developed a severely pruritic subcutaneous nodule on her anterior right thigh at the injection site three weeks after the administration of the aluminum-containing DTaP-IPV (Kinrix) vaccine. The nodule was eventually excised 14 months after its initial appearance, after which her symptoms resolved. Histologic inspection demonstrated a dense, deep dermal and subcutaneous nodular mixed infiltrate of lymphocytes, histiocytes, and eosinophils, with germinal center formation. The bluish, amphophilic granular cytoplasm found in most of the histiocytes is a characteristic feature of “aluminum granulomas.” This adverse reaction should be considered in any patient presenting with similar findings in the weeks following a DTaP-IPV vaccination or other aluminum-containing vaccines. Furthermore, the self-limiting tendency of these nodules should not preclude affected patients from any future vaccinations, though vaccines without aluminum should be preferentially selected when possible.

Original languageEnglish (US)
Pages (from-to)e17-e19
JournalPediatric dermatology
Volume36
Issue number1
DOIs
StatePublished - Jan 1 2019

Keywords

  • aluminum granuloma
  • dermatopathology
  • pediatric dermatology
  • subcutaneous nodule
  • vaccine site reactions
  • vaccines

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Dermatology

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