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

[Oner Ozdemir]

Dear Dr Lederman;

It has been well known that NK-cell qualitative and quantitative defects go
with recurrent viral infections such as HSV.
Your patient's NK cell percentage* a little low (6%).* We would expect it
betwen 7- 31 (13)% for a normal adult.
I agree that you should check her NK cytotoxicity from PBMNCc as well.

Regads;

Oner Ozdemir, MD

-- 
Öner Özdemir, MD
Chief and Assoc. Prof. Pediatrics
Republic of Turkey, Ministry of Health, İstanbul Medeniyet University,
Göztepe Research and Training Hospital
Göztepe, Kadıköy, İSTANBUL -TÜRKİYE.


On Wed, Jul 25, 2012 at 8:37 PM, Boyce, Thomas G., M.D. <
Boyce.Thomas at mayo.edu> wrote:


> **

> 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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>

> ** **

>

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