[CIS PIDD] : [cis-pidd] current opinions on live vaccines and DiGeorge Syndrome

[Javier Chinen]

Joyce, It would be informative to have lymphocyte proliferation to specific antigens and if he had cardiac surgery and was thymectomized. Also if his CD4 cells are mostly of naive phenotype. I believe the low number of cases due to immunization reported has made it difficult to establish a cut-off for absolute T cell number, although a reference for immunodeficiency could be the CD4 ranges used for HIV infection.Optimally you would expect to have all pneumococcal serotypes antibody titers that are in PCV13 at protective levels. I would include in your decision whether the naive T cell compartment and proliferation to specific antigen are preserved, whether the family is willing to accept the risk and how good is vaccination coverage in the child's community. Javier 

> 

> From: Joyce Yu [mailto:jeyu74 at gmail.com]

> Sent: Monday, April 01, 2013 06:29 PM Pacific Standard Time

> To: CIS-PIDD <cis-pidd at lists.clinimmsoc.org>

> Subject: [cis-pidd] current opinions on live vaccines and DiGeorge Syndrome

> 

> Hi all,

> 

> I'm taking care of a 1.5 yo boy with DiGeorge Syndrome and have been asked whether he can get the live vaccines.

> 

> He has otherwise been generally well (aside from his cardiac and feeding issues).

> 

> Most recent testing showed:

> CD4 859 (1204 at prior testing)

> CD8 721 (1921 prior)

> NK 415 (757 prior)

> CD19 2182 (3534 prior)

> 

> He has normal response to PHA, ConA, and slightly decreased response to PWM. He also has NL IgG, IgM, IgA and protective titers to diphtheria, tetanus, Hib, and pneumococcal (+ titers to 8 of 14)

> 

> Since he appears to have decent T and B cell function, I am thinking that he has little risk for receiving the MMR and varicella. However, his lymphocyte counts have decreased in the past year or so, so I am not sure whether I should take that into consideration. I was wondering whether anyone has looked further into the issue of cutoffs for lymphocyte counts, or could I make my decision based on functional studies despite decreasing absolute number of lymphocytes?

> 

> Thanks,

> 

> Joyce Yu

> Weill Cornell Medical Center

> 

> ---

> 

> The CIS-PIDD listserv is supported by:

> 

> [http://www.clinimmsoc.org/UserFiles/image/cis-pidd-list-logo_v1.jpg]

> The science & practice of human immunology

> 

> P: +1.414.224.8095

> E: info at clinimmsoc.org

> 

> Not a member of CIS? Please visit www.clinimmsoc.org<https://cis.execinc.com/edibo/Signup> to join!

> 

> You are currently subscribed to cis-pidd as: ajunker at cw.bc.ca<mailto:ajunker at cw.bc.ca>.

> To unsubscribe click here: http://lm.clinimmsoc.org/u?id=183824526.94d147448fe98e3a38013fe04eb9ae79&n=T&l=cis-pidd&o=43073700

> 

> ---

> 

> The CIS-PIDD listserv is supported by:

> 

> [http://www.clinimmsoc.org/UserFiles/image/cis-pidd-list-logo_v1.jpg]

> The science & practice of human immunology

> 

> P: +1.414.224.8095

> E: info at clinimmsoc.org

> 

> Not a member of CIS? Please visit www.clinimmsoc.org<https://cis.execinc.com/edibo/Signup> to join!

> 

> You are currently subscribed to cis-pidd as: fabian.hauck at med.uni-muenchen.de<mailto:fabian.hauck at med.uni-muenchen.de>.

> To unsubscribe click here: http://lm.clinimmsoc.org/u?id=188256718.ff9fe98296347b85fa9ea70e8561a6f2&n=T&l=cis-pidd&o=43074034

> 

> 

> ---

> The CIS-PIDD listserv is supported by the Clinical Immunology Society

> The science & practice of human immunology

> 

> P: +1.414.224.8095

> E: info at clinimmsoc.org

> 

> Not a member of CIS? Please visit www.clinimmsoc.org to join!

> 

> You are currently subscribed to cis-pidd as: chinej20 at hotmail.com.

> To unsubscribe click here: http://lm.clinimmsoc.org/u?id=183824420.44a1efe34c59bc95780b9f7b51291cb5&n=T&l=cis-pidd&o=43075349

> or send a blank email to leave-43075349-183824420.44a1efe34c59bc95780b9f7b51291cb5 at lists.clinimmsoc.org

 		 	   		  
---
The CIS-PIDD listserv is supported by the Clinical Immunology Society
The science & practice of human immunology

P: +1.414.224.8095
E: info at clinimmsoc.org

Not a member of CIS? Please visit www.clinimmsoc.org to join!

You are currently subscribed to cis-pidd as: pagid at list.clinimmsoc.org.
To unsubscribe click here: http://lm.clinimmsoc.org/u?id=183939985.3ea13d40a15475ac00ebbd9cd8a37d6d&n=T&l=cis-pidd&o=43076616
or send a blank email to leave-43076616-183939985.3ea13d40a15475ac00ebbd9cd8a37d6d at lists.clinimmsoc.org
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://seven.pairlist.net/pipermail/pagid/attachments/20130402/1353987e/attachment-0001.htm>