Q:

4/7/2013
One week after close contact with a IBD flare up, a 16 year old becomes gluten sensitive like the IBD flare up. A few months later, she presents with rectal bleeding within one week of MCV4 vaccine. Colonoscopy showed mild proctitis and two mild large colon inflammations. Small colon intact no damage, indeterminate colitis. After adhering to a gluten free diet, rectal bleeding becomes less. Now taking Mesalamine1,000mg twice a day with suppository.

All blood results normal. Patient has 1/2 the HLA DQ 2 gene, HAL DQ A1 05. White blood cells in normal range, but are decreasing at rapid pace. NO immature cells. Unusual case, not seen before. Now What? How to test for MCV4 vaccine allergy/reaction?

A:

Thank you for your inquiry.

Unfortunately, I am afraid I can be of little help. I believe that any questions regarding the condition of the patient you described would be better handled by a gastroenterologist since the condition from which she is suffering usually does not fall within our purview.

In addition, unfortunately testing to meningococcal vaccine, although it can be done, would not be appropriate for the patient under discussion. Testing is only predictive of a future immediate hypersensitivity reaction (hives, shock, wheezing) - that is, an acute urticarial or anaphylactic event. It would not be of any help in determining whether meningococcal vaccine was responsible for the patient’s present condition.

Thank you again for your inquiry and we hope this response is helpful to you.

Sincerely,
Phil Lieberman, M.D.

AAAAI - American Academy of Allergy Asthma & Immunology