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Case Reports in Rheumatology
Volume 2012, Article ID 785028, 3 pages
Case Report

Rheumatoid Arthritis and Swine Influenza Vaccine: A Case Report

1Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA
2Division of Rheumatology, University of Texas Medical Branch, Galveston, TX 77555, USA

Received 3 April 2012; Accepted 15 June 2012

Academic Editors: D. Aeberli, J. V. Dunne, and F. Schiavon

Copyright © 2012 Gurjot Basra et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Rheumatoid arthritis (RA) is the most common chronic inflammatory joint disease. Multiple scientific articles have documented that vaccinations for influenza, MMR, and HBV, to name a few, could be triggers of RA in genetically predisposed individuals. However, there is limited data regarding the association of swine flu vaccine (H1N1) and RA. We report the case of a Mexican American female who developed RA right after vaccination with H1N1 vaccine. Genetically, RA has consistently been associated with an epitope in the third hypervariable region of the HLA-DR 𝛽 chains, known as the “shared epitope”, which is found primarily in DR4 and DR1 regions. The presence of HLA-DRB1 alleles is associated with susceptibility to RA in Mexican Americans. Hence, certain individuals with the presence of the “shared epitope” may develop RA following specific vaccinations. To our knowledge, this is the first reported case of RA following vaccination with the swine flu vaccine.