[PAGID] patient who lacks long-term memory antibody responses

[Prof. Dr. Antonio Condino Neto]

I have one 8 year boy and his 6 year old sister with persistent  
respiratory infections. Both lack anti-pnemococcal antibodies.

After long term Bactrim the boy developed S Johnson Sndr and almost died.

So decided to start IVIG for both and they are very fine now.

Have no idea about the molecular defect

-- 
Antonio Condino-Neto, MD, PhD
Associate Professor - Department of Immunology
Institute of Biomedical Sciences - University of São Paulo
1730 Lineu Prestes Avenue, São Paulo - SP. ZIP 05508-000. Brazil
Tel (55) (11) 3091-7387 / Fax (55) (11) 3091-7224



Citando "Chinen, Javier" <jxchinen at texaschildrens.org>:


> One of my Hyper IgE patients (STAT3 mutation confirmed) and another  

> with a not identified genetic syndrome (extensive work up done) have  

> the same phenotype. The HIES patient was on IVIG, now he is well  

> with just antibiotic prophylaxis, decisions on IVIG were made based  

> on family comfort with the potential risk of overwhelming infection  

> and access to medical care. The second patient is OK with antibiotic  

> prophylaxis (Bactrim in both cases).

> Lack of memory humoral responses is reported in HIES. It would be  

> interesting to check CD27 B cells.

> Javier

> ________________________________

> From: pagid-bounces at list.clinimmsoc.org  

> [mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Howard M  

> Lederman

> Sent: Thursday, July 16, 2009 1:50 PM

> To: PAGID LISTSERV

> Subject: [PAGID] patient who lacks long-term memory antibody responses

>

>

> I have a fascinating  12 yr old male patient with a history of  

> recurrent infections (mostly upper and lower respiratory tract).  No  

> individual infection has been overwhelmingly severe, but the sum of  

> all infections leads to a significant number of school absences.

>

> He has low IgG and IgM levels with normal IgA levels.  He makes  

> normal IgG antibody responses to a wide variety of vaccines, but  

> does not seem to be able to maintain long-term immunity.  (See  

> attached spreadsheet.  Sheet 1 tabulates the antibody and  

> immunglobulin levels; sheet 2 lists the immunizations.)

>

> Is this a pattern that others have seen?    I am open to any ideas  

> for further evaluation.  Would anyone offer this child gamma globulin?

>

> Howard

> Howard M. Lederman, M.D., Ph.D.

> Professor of Pediatrics, Medicine and Pathology

> Division of Pediatric Allergy and Immunology

> Johns Hopkins Hospital - CMSC 1102

> 600 N. Wolfe Street

> Baltimore, MD 21287-3923

> Phone: 410-955-5883

> Fax: 410-955-0229

> Email: Hlederm1 at jhem.jhmi.edu

>

> WARNING: E-mail sent over the Internet is not secure.

> Information sent by e-mail may not remain confidential.

>

> DISCLAIMER: This e-mail is intended only for the

> individual to whom it is addressed. It may be used only in  

> accordance with applicable laws. If you received this e-mail by  

> mistake, please notify the sender and destroy the e-mail.

>

>

>

> ------------------------------------------------------------------------------

> CONFIDENTIALITY NOTICE:

>  The information in this e-mail may be confidential and/or

>  privileged.  If you are not the intended recipient or an

>  authorized representative of the intended recipient, you

>  are hereby notified that any review, dissemination, or

>  copying of this e-mail and its attachments, if any, or

>  the information contained herein is prohibited.  If you

>  have received this e-mail in error, please immediately

>  notify the sender by return e-mail and delete this e-mail

>  from your computer system.  Thank you.

> ==============================================================================

>




----------------------------------------------------------------
This message was sent using IMP, the Internet Messaging Program.