[CIS PIDD] [cis-pidd] 18yo M with antibody deficiency

[CIS-PIDD]

Colleagues:

I have followed an 18yo male who had a history of recurrent URIs associated with IgA deficiency and poor antibody responses to pneumococcal polysaccharide antigens (Pneumovax).

He has had no significant infections for at least 5 years.

His primary MD wanted to check his immune status prior to the young man going to college.  The patient received Menactra (conjugated N. men A, C, Y, W-135 polysaccharides) and Prevnar (conjugated 13 serotypes of S. pneumo polysaccharides) on July 28.

Labs drawn on September 1 showed:

-       Positive antibodies to N. men A only

-       Positive antibodies to ONE serotype of S. pneumo

-       Normal IgG and Ig M levels.

The lack of response to conjugated polysaccharide vaccines is of concern to me.

Would you suggest:

-       Continue observation and urgent use of antibiotics for febrile episodes?

-       Antibiotic prophylaxis?

-       Immunoglobulin replacement?

-       Other?

-
Thank you for your consideration.

Joe Church
Children's Hospital Los Angeles


---------------------------------------------------------------------
CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, 
is for the sole use of the intended recipient(s) and may contain confidential
or legally privileged information. Any unauthorized review, use, disclosure
or distribution is prohibited. If you are not the intended recipient, please
contact the sender by reply e-mail and destroy all copies of this original message.  

---------------------------------------------------------------------


---
You are currently subscribed to cis-pidd as: pagid at list.clinimmsoc.org.
To unsubscribe click here: http://cts.dundee.net/u?id=96396833.5a9591ccd1e327fe6bc4d1543298c482&n=T&l=cis-pidd&o=3118412
or send a blank email to leave-3118412-96396833.5a9591ccd1e327fe6bc4d1543298c482 at lyris.dundee.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <https://pairlist7.pair.net/pipermail/pagid/attachments/20150910/c78b6c8c/attachment-0001.html>