Injection-site granuloma due to aluminum

Abstract

Three patients had subcutaneous nodules at the sites of previous injections of vaccine containing tetanus toxoid. Biopsy and microscopic findings in all three cases showed foci of granulomatous inflammation, consisting of lymphoid follicles, in the deep dermis and subcutaneous tissues and a surrounding infiltrate of lymphocytes, histiocytes, plasma cells, and eosinophils. Occasional zones of eosinophilic necrosis were seen within the inflammatory foci, and surrounding dense fibrous bands were present in some areas. A solochrome-azurin stain showed aluminum crystals in the nodules from two patients. From the evidence available, we believe that these nodules are a complication of inoculations with aluminum-containing vaccines.

Effectiveness and tolerability of 3‐year lanreotide Autogel® treatment in patients with acromegaly

“…Clinical and histological findings were consistent with lanreotide‐containing foreign‐body granulomas. Recurrent subcutaneous nodules at injection sites have been associated with insulin, aluminium‐containing tetanus toxoid vaccines 24 or LHRH analogues coupled to lactic acid polymers 25 . Our report indicates that subcutaneous injection‐site granuloma can occur with lanreotide Autogel injections, as reported previously with octreotide LAR 26 .…”

The impact of aluminium in acid‐suppressing drugs on the immune response of BALB/c mice

“…Macroscopical and histological examination of cutaneous and subcutaneous tissue showed granuloma formation at injection sites in sucralfate-and aluminium-treated mice. This was already observed in our earlier studies [13] and is most probably ascribed to the foreign, non-degradable material alum [31].…”

(55) Persistent vaccination granuloma due to aluminium hypersensitivity

“…committee on clinical trials of influenza vaccine 1955). Persistent nodules, as observed here, have been described more recently and the histology has shown characteristic granulomata containing aluminium crystals (Fawcett & Smith, 1984). The positive patch tests in this patient and also in 10 other patients tested against Finn chambers and aluminium salts (unpublished data), strongly suggest that these persistent reactions are due to hypersensitivity to the aluminium adjuvant in adsorbed vaccine.…”