[CIS PIDD] [cis-pidd] low CD4 counts after partial thymectomy in cardiac patient

[Nacho Gonzalez]

Dear Allyson,
there is no need to be worried,  I've been following that cohort (Dr
Mancebo's PhD) and all of them are asymptomatic despite CD4 lymphopenia.
Best regards ,

Luis Ignacio González Granado
Immunodeficiencies Unit
Hospital 12 octubre
Madrid
El 22/4/2015 21:49, "Larkin, Allyson" <allyson.larkin at chp.edu> escribió:

> Dear Colleagues,
>
>
>
> I recently saw a 9 y/o male for a second opinion of lymphopenia. He has a
> hx of tetralogy of fallot (s/p repair and partial thymectomy). He had
> immune studies done when he presented with a year of sinus disease. CD3 and
> CD4 counts are low (CD3 346, CD4 193), CD19 and CD16 are normal.
> Proliferation is close to normal. Immunoglobulins and vaccine response are
> normal. FISH for 22q11 is normal.
>
>
>
> I think it's likely that his counts could be low secondary to his partial
> thymectomy. He has never had fungal or opportunistic infections.
>
>
>
> Has anyone ever followed similar patients and considered using
> pneumocystis prophylaxis in the setting of the low CD4 counts?
>
>
>
> My understanding is that infection risk has been looked at in neonates who
> had thymectomy in the setting of surgical procedures for congential heart
> disease. In a three year f/u study, these children did well, despite
> profound lymphopenia, with no more serious infections than healthy
> controls. However, this has not been followed further out (Mancebo, E. et
> al. Longitudinal analysis of immune function in the first 3 years of life
> in thymectomized neonates during cardiac surgery. Clinical and Experimental
> Immunology, 154: 375-383).
>
>
>
> Thanks in advance for your thoughts,
>
>
>
> Allyson Larkin, MD
>
> Assistant Professor of Pediatrics
>
> Children's Hospital of Pittsburgh of UPMC
>
> allyson.larkin at chp.edu<mailto:allyson.larkin at chp.edu>
>
> 412-692-7885
>
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