Introduction.Patients with inflammatory rheumatic disease are in increased risk of infection,which is still leading cause of mortality in rheumatoid arthritis and systemic lupus erythematosus (SLE). Vaccination in these subjectsmaydecrease the risk of severe infectiouscomplications, but also might lead to flare up of the disease. Case report. A female, 24 years old patient developed 3 weeks after vaccination severe SLE with multiorgan involvement (meningoencephalitis, polyserositis, pancytopenia, nephritis, myositis, secondary antiphospholipid syndrome) and high autoantibodies levels. Despite of intensive intravenous corticosteroids, followed with oral therapy, the condition deteriorated and only plasmapheresis and IV pulse cyclophosphamide (6 pulses) reversed the critical state. Therapy led finally to complete remission of the diseases. After 1 year follow-up the patient has been treated only with maintaining doses of methylprednisolone, azathioprine and warfarin, she complained only for steroid cataract. Respectively, it has been revealed, that the patient was in the age of 9 years treated temporarily for juvenile idiopathic arthritis, which has been long term remitted. Conclusion. A risk of induction of a new autoimmune disease after vaccination in healthy subjects is very low and wide experiences show, that vaccination is safe (excluding alive vaccines) also in patients with inflammatory rheumatic diseases with stabilized disease. Flares cannot be excluded, but they are reported rarely and have not been observed in controlled studies. In patients treated with high doses of immunosupressive drugs the efficacy of vaccination may not be sufficient and a check of induced antibodies titres is recommended.

        Key words: inflammatory rheumatic disease, rheumatoid arthritis, systemic lupus, vaccination