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Aluminium Granulomata (Aluminum) at Injection Site

Purpose: To identify a patient with an aluminium (aluminum) granuloma at the site of drug injections.

Description

An aluminium salt (in England, aluminum elsewhere) may be present in injectable pharmaceuticals such as vaccines. The salt (such as aluminum chloride) may be added to help suspend particles with the active compound into solution. A person may develop a persistent nodule at the site where an aluminum-containing formulation has been injected.


Clinical features:

(1) The patient develops a clinical nodule at the site of drug injections.

(2) The injected drugs contain an aluminium salt.

(3) There is no other explanation for the findings such as infection.

 

Histologic features of a biopsy taken of the nodule:

(1) a variety of histologic patterns

(1a) nonspecific panniculitis

(1b) pseudolymphoma

(1c) lupus profundus-like

(1d) necrobiotic granuloma resembling granuloma annular

(2) presence of a large number of histiocytes with a violaceous and granular cytoplasm

 

Energy dispersive X-ray microanalysis of the histiocytes shows the presence of aluminium.


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Specialty

Objective

ICD-10