[CIS PIDD] Adult with recurrent HSV-1 and VZV infections

[Boyce, Thomas G., M.D.]

NK cell function?
GATA2?  is her monocyte count NL?
 
Thomas G. Boyce, MD, MPH 
Pediatric Infectious Diseases and Immunology 
Mayo Clinic 
Rochester, MN 55905 
phone: 507-255-8464 
fax: 507-255-7767 


________________________________

From: pagid-bounces at list.clinimmsoc.org
[mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Howard Lederman
Sent: Wednesday, July 25, 2012 12:32 PM
To: pagid at list.clinimmsoc.org
Cc: Beth Younger
Subject: [CIS PIDD] Adult with recurrent HSV-1 and VZV infections



I have just seen a 36 y/o female who was healthy until 18 months ago
when she began to develop recurrent episodes of peri-oral HSV outbreaks
as well as multiple episodes of shingles.  None of the infections has
been terribly severe, but she does have post-infectious neuralgias.  She
has otherwise been well except for a long h/o mild environmental
allergies and intermittent sinus infections.  She has no HIV risk
factors.

 

Lab tests have shown normal IgG, IgA, IgM;  IgG Ab to HSV-1 (but not
HSV-2), VZV, and a strong response to a recent Pneumovax; normal
T-cells: 83% CD3 (2144 /uL) / 38% CD4 (997/uL) / 38% CD8 (986/uL; normal
NK numbers:  6%CD16/CD56; and negative HIV ELISA.  CBC completely normal
except for mild anemia (Hgb l0.7).

 

Is there any additional testing that may yield useful information to
explain this problem acquired so late in life?

 

Has anyone tried to immunize such a patient with Zostavax in the hope
that it would stimulate anti-VZV immunity better than a viral
re-activation?

 

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 jhmi.edu

 

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