[CIS PIDD] [cis-pidd] 13+ yo with chronic thrush

[Church, Joseph]

Thank you, Jen.  The patient has no other symptoms and has not been on antibiotics.  I will look for STAT1.  JC

From: Heimall, Jennifer [mailto:heimallj at email.chop.edu]
Sent: Thursday, July 11, 2013 5:49 PM
To: CIS-PIDD
Subject: RE: [cis-pidd] 13+ yo with chronic thrush

I wonder if it might be useful to check Th17 cell populations? If low maybe consider STAT1 mutations?
Also does she have vaginal thrush or finger/toennail thrush?
I assume she has not been on recurrent antibiotics for the tonsilar enlargement?
Jen Heimall

-----Original Message-----
From: Church, Joseph [JChurch at chla.usc.edu]
Received: Thursday, 11 Jul 2013, 7:51pm
To: CIS-PIDD [cis-pidd at lists.clinimmsoc.org]
Subject: [cis-pidd] 13+ yo with chronic thrush
Colleagues:

I have followed a 13+ year-old African American girl who reportedly developed thrush at 10 years of age.

Growth and development have been normal.  She does not routinely use inhaled steroids.  Moderately severe posterior pharyngeal candidiasis (culture-documented) has been noted at several visits.  Her only other physical finding is enlarged tonsils.  She has had no other infections.  She has no signs or symptoms of autoimmune disease.  Her thrush is transiently responsive to anti-fungal therapy.

HIV was negative.  She has had mild lymphopenia that was reflected in borderline T, B and NK numbers, but mitogen and candida LPAs were present.  She generated normal antibody responses to Pneumovax.

What am I missing here?

Joe Church
Children's Hospital Los Angeles







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