Belgian doctors have reported that two of their patientsdeveloped serious signs of central nervous system damageafter receiving a recombinant hepatitis B vaccine.

Six weeks after receiving the vaccine, the two patients showedsigns and symptoms of demyelination, or loss of the nervecoating, in their central nervous system, the doctors reported inthis week's issue of the British journal The Lancet.

One patient had previously been diagnosed with a relapsingform of multiple sclerosis, and both showed immune markersthat have been linked with MS.

A previously well patient at first noticed weakness and tinglingin her right arm and leg, then developed visual loss and partialparalysis. The patient with MS, who had been in remission,entered a coma after receiving the vaccine. Although the comawas resolved with treatment, she remains partially paralyzed.

The vaccine was produced by SmithKline Beecham. ChironCorp.'s hepatitis B vaccine is sold by Merck & Co.

Various neurologic problems have been linked to blood-derived vaccines for hepatitis B, the doctors noted, but "fewsuch incidents have been associated with the use ofrecombinant vaccines, although there have been two reports ofoptic neuritis and one of Guillain-Barre syndrome," they added.

While no causal link can be proved in their two cases, thedoctors concluded that "recombinant hepatitis B vaccinationmight best be avoided in patients with known multiplesclerosis." -- Roberta Friedman, Ph.D.

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