[PAGID] vaccination and complement activation

[sullivak at mail.med.upenn.edu]

Don.t vaccinate.  Rarely can precipitate an HUS attack.

Kate
Sent from my Verizon Wireless BlackBerry

-----Original Message-----
From: 김예진 <yaejeankim at skku.edu>
Date: Thu, 10 Jun 2010 14:03:48 
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 
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