[CIS PIDD] [cis-pidd] Yellow Fever Vaccine in sIgAD

[Yeşim Yılmaz Demirdağ]

Thank you all,
I don't agree with CDC's recommendations for this specific patient either.
What about their recommendation on Yellow Fever vaccine in sIgAD
patients? Should it be contraindicated in these patients? If yes,
then everybody should be checked for IgA deficiency before they receive the
vaccine ( I don't agree with that either).
Thanks again,
Yesim



On Wed, Jul 3, 2013 at 11:27 AM, Cunningham-Rundles, Charlotte <
charlotte.cunningham-rundles at mssm.edu> wrote:


> The CDC is of course wrong on this, but expect that is the only  answer

> they

> can give on such a  phone call.

>

>

>

> Charlotte Cunningham-Rundles, MD, PhD

> Departments of Medicine and Pediatrics

> The David S Gottesman Professor

> The Immunology Institute

> Mount Sinai School of Medicine

> 1425 Madison Avenue

> New York, NY 10029

> Phone: 212 659 9268

> Fax: 212 987 5593

> Email: Charlotte.Cunningham-Rundles at mssm.edu

>

>

>

>

> > From: Jack R <jroutes at mcw.edu>

> > Reply-To: "cis-pidd at lists.clinimmsoc.org" <cis-pidd at lists.clinimmsoc.org

> >

> > Date: Wed, 3 Jul 2013 13:08:51 +0000

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

> > Subject: Re: [cis-pidd] Yellow Fever Vaccine in sIgAD

> >

>  > I disagree with the CDC recommendation and do not believe your patient

> has IgA

> > deficiency

> >

> >

> >

> >

> > John M. Routes, MD

> > Chief, Section of Allergy and Clinical Immunology

> > Professor of Pediatrics, Medicine, Microbiology and Molecular Genetics

> > Department of Pediatrics

> > Children's Hospital of Wisconsin

> > Medical College of Wisconsin

> > 9000 W. Wisconsin Ave.

> > Milwaukee, WI  53226-4874

> > Phone: Office 414-266-6840

> > Fax: 414-456-6487 (Clinical)

> > Fax: 414-456-6323 (Laboratory)

> > Email: jroutes at mcw.edu<mailto:jroutes at mcw.edu>

> >

> >

> >

> >

> >

> > On Jul 2, 2013, at 6:21 PM, Yeşim Yılmaz Demirdağ

> > <dryesimyilmaz at gmail.com<mailto:dryesimyilmaz at gmail.com>> wrote:

> >

> > Dear all,

> >

> > I would like to bring the "Yellow Fever vaccine and IgA deficiency"

> topic back

> > to the group discussion. Last discussion concluded that YF vaccine is not

> > contraindicated in IgA deficiency.

> >

> > I received an e-mail today from a colleague. His patient, a 25 yo woman

> with

> > history of Grave's disease, is planning to visit Ghana and she needs

> Yellow

> > Fever vaccination. She had slightly low IgA and IgM 3 years ago (checked

> > during Grave's work-up). She does not have recurrent infections and she

> is

> > otherwise healthy. She and her father contacted CDC and were told that YF

> > vaccine is contraindicated in selective IgA deficiency and they were

> given

> > this reference  http://www.cdc.gov/mmwr/pdf/rr/rr6002.pdf  (Table 13 on

> page

> > 48). I was not aware of this publication, so I wanted to let you all know

> > about it and ask your opinion.

> >

> > Back to the patient: Her recent IgA level is 49 mg/dl (70-312), IgM is 43

> > mg/dl (56-352) and IgG is 913 mg/dl (639-1349).  I am not impressed by

> these

> > values. But the family is reluctant. What would you recommend for this

> > patient? Does she have selective IgA deficiency? What about slightly low

> IgM?

> > Do you think this combination should be a contraindication for the

> vaccine?

> >

> > Dewton, you mentioned that YF vaccine is widely used in inland Brazil.

> Do you

> > have any data on the frequency of IgA deficiency in patients who

> developed

> > severe reaction to this vaccine?

> >

> > Thank you,

> >

> > Yesim

> >

> >

> >

> > Yesim Yilmaz Demirdag, MD

> > Assistant Professor of Pediatrics

> > Division of Allergy and Immunology

> > Columbia University Medical Center

> > New York

> >

> >

> >

> >

> >

> >

> >

> >

> > On Wed, Jun 19, 2013 at 1:13 PM, Church, Joseph

> > <JChurch at chla.usc.edu<mailto:JChurch at chla.usc.edu>> wrote:

> > Colleagues:

> >

> > A 20+ year old patient is traveling to Africa and is recommended to

> receive

> > Yellow Fever Vaccine.

> >

> > She has selective IgA deficiency.  Assuming she does not have an antibody

> > deficiency is there a contraindication to giving  her the YF vaccine?

> >

> > Joe Church

> > Children’s hospital Los Angeles

> >

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