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

[Joyce Yu]

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

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