“We have recently observed a patient who developed Rhumatoid Arthritis three weeks after a second dose of tetanus toxoid. A 34 year old woman received two doses of tetanus toxoid in November and December 1986. A week after the second dose she developed severe pain with erythema and in duration measuring 10cm in diamater at the site of injection over the left deltoid muscle. This severe local reaction lasted 10 days. A few days after the erythema and induration started to fade the patient developed a symmetrical inflammatory polyarthritis involving proximal interphalangeal, metacarpophalangeal, wrist, elbow, shoulder, knee, and the metatarsophalangeal joints. The arthritis was severe with early morning stiffness lasting several hours. There was no past history of arthritis, inflammatory bowel disease, iritis, back pain, psoriassis, or recent infection and no family history of inflammatory arthritis.”

PubMed