[CIS PIDD] [cis-pidd] Only diphteria response low????

[Nacho Gonzalez]

Same experience,
Regards,

Luis Ignacio Gonzalez Granado
Immunodeficiencies
Hospital 12 octubre
Madrid. Spain
El 28/06/2013 15:53, "Howard Lederman" <hlederm1 at jhmi.edu> escribió:


>  We have seen a couple of patients like this who respond to everything but diphtheria toxoid.  I don't consider this to be biologically important.

>

> Howard

>

> Seppänen Mikko <Mikko.Seppanen at hus.fi> wrote:

>

>

>  Dear all,

>

> a colleague of ours visited my office in April, she has moderately severe

> asthma and recurrent URT infections, and in my mind clinically no PIDD

> phenotype. No severe invasive infections and no p.o. corticosteroids for

> 2.5 years. She has no syndromic features and clinically only mild viral

> infections (w. prolonged asthma exacerbations), no noted chronic viral

> infections, and all her ab levels were normal in plasma, IgE only 58 (but

> capable of its production).

>

> She had receved tetanus+diphtheria booster 2 years previously. We did

> check her vaccine responses since C.diphtheriae-Abs were low (and w/o

> vaccination her StpnAbs were also low), to rule out mild adult SPAD (had

> she not been an immunology-oriented colleague, I probably would not have

> checked any further).

>

> After vaccination she has VERY strong responses to both strong

> T-B-ag/tetanus, and PnP/ B-ags (9/10 respond, up to titers of 180), but

> does not respond to weak T-B ag/ diphtheria (0.03-0.07 SPU/ml, threshold in

> our lab 0.1).

>

> Have never seen this ab response pattern before, I clinically think it

> might be irrelevant (at least there isn't much I could do to help her), but

> would like to hear whether anyone in the group has seen this, does it ring

> any bells????

>

> Maybe prof Ricardo Sorensen has seen this? We have not tested her memory

> Bs (J Clin Immunol. 2013 Jan;33 Suppl 1:S57-61).

>

> Yours

>

> mikko seppänen,

> md phd

> finland

>

>

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