[PAGID] vaccination and complement activation

[Verbsky, James]

This child appears to have a factor H deficiency.  This is more concerning than vaccine responses.  I would contact John Atkinson at Washington University school of medicine to aid in the management of this child as he is an expert in this field.

His email is jatkinso at im.wustl.edu..tell<mailto:jatkinso at im.wustl.edu..tell> him James Verbsky referred this case..he will be able to help you in the treatment of this child.  I dont know of the vaccine responses of factor H deficiency


James Verbsky MD/PhD
Assistant Professor of Pediatrics and Microbiology and Molecular Genetics
Medical College of Wisconsin
Milwaukee, WI  53226

________________________________
From: pagid-bounces at list.clinimmsoc.org [pagid-bounces at list.clinimmsoc.org] On Behalf Of 김예진 [yaejeankim at skku.edu]
Sent: Thursday, June 10, 2010 12:03 AM
To: pagid at list.clinimmsoc.org
Subject: [PAGID] vaccination and complement activation


Dear all,



I have a question about an issue of vaccination and complement system activation in a child described below...

4 month-old female with hx of atypical hemolytic uremic syndrome d/t partial factor H deficiency.



Gene sequencing revealed two mutation for factor H genes. Factor H level was measured low as 20~30% of normal values. ADAMTS13 Gene Mutation was not detected.

After she had HUS...complement  levels were followed and C3 and C4 levels were shown below.



　       unit    2-17-2010       3-4-2010        3-26-2010       5-6-2010        5-13-2010       5-27-2010       5-29-2010       5-29-2010       5-30-2010
C3, Serum (Complement C3)       ㎎/㎗     ▼31.7   97.3    122.4   ▼68.1   ▼76.4   ▼85.6   136.5   126.5   99.4

C4, Serum

(Complement C4)
        ㎎/㎗     ▼4.0    16.9    25.2    10.9    14.3    18.5    26.6    20.3    21.6

CH50    U/㎖     ▼8.1    ▲54.91  ▲51.87  29.19   44.36   ▲51.87  ▲59.15  　       ▲47.09

 Currently her condition is stable but we have some concerns about possible vaccination associated complement system activation since at the age of 2 months right after the vaccination her complements were depressed and the sx recurred...per my nephrology colleauge. She is 4 month old and has many vaccine to get in the future...



I see some literature mentioning comlement activation by BCG. What about other routine childhood vaccination?

Any comments will be appreciated.



YaeJean

--------------------------------------------------------------------------

Yae-Jean Kim, MD

Assistant Professor

Division of Infectious Diseases

Department of Pediatrics

Sungkyunkwan University School of Medicine

Samsung Medical Center

50 Irwon-dong Gangnam-gu

Seoul, Korea

Tel)  +82-2-3410-0987

Fax) +82-2-3410-0043

[http://mail.skku.edu/servlet/CheckRead?key=1276146228944&folderID=yaejeankim@skku.edu:002outbox&db=CRINITY&table=CRMAIL&outBoxSEQ=&rcpt=pagid@list.clinimmsoc.org]