[CIS PIDD] [cis-pidd] CVID and Shingles

[Klaus Warnatz]

Dear Mike, 

I don't have personal experience with shingles vaccination in CVID patients. 
my thoughts on it would be, if the patient has recurrent shingles he might as well have some underlying cellular immunodeficiency.  I agree with Charlotte are these documented and what does recurrent mean? Are these outbreaks restricted to dermatomes at a time?
if not then it strongly suggests cellular immunodeficiency. I would be rather hesitant with vaccination and if documented and a substantial problem I would rather go for acyclovir prophylaxis. 
Are there any other signs of cellular immunodeficiency? is she for any reason on immunosuppressive therapy? can one alter this?
what is her t cellular status?

These would be my thoughts

best regards

Klaus
Prof. Dr. med. Klaus Warnatz

UNIVERSITÄTSKLINIKUM FREIBURG
University Medical Center Freiburg
Center for Chronic Immunodeficiency
Division of Rheumatology and Clinical Immunology

Tel: +49-761-270-77640 / FAX -71000 / Pager: 12-7100

Breisacher Str. 117, 79106 Freiburg, Germany
klaus.warnatz at uniklinik-freiburg.de
http://www.uniklinik-freiburg.de/cci

Am 01.05.2014 um 20:53 schrieb Cunningham-Rundles, Charlotte:


> Is she on IVIG and is the shingles documented… ? 

> 

> 

> 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: Michael Blaese <mblaese at comcast.net>

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

> Date: Thursday, May 1, 2014 1:31 PM

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

> Subject: [cis-pidd] CVID and Shingles

> 

> IDF has received the following inquiry. 

>  "I have CVID and I get outbreaks of shingles. Has anyone had success with the shingles vaccination? Or is that too risky for someone with CVID?"

> 

> CDC still recommends against use of the vaccine in individuals with primary immunodeficiency.  Any thoughts or experience with this situation?

> 

> Mike

> 

> R. Michael Blaese, M.D.

> Medical Director

> Immune Deficiency Foundation

> 

> 

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