[CIS PIDD] [cis-pidd] SPAD and sIgG2+4 deficiency

[CIS-PIDD]

I think Joe's approach is very reasonable. I would point out, however, that
in my experience the overwhelming majority of SAD/Ig subclass deficient
patients have already had live virus vaccines by the time they come for
evaluation. I don't recall ever having seen a patient like this who had a
problem with MMR. Part of the intake history focuses on active infection
following vaccination. These patients seem to do just fine with protein
antigens. Rarely, SAD/Ig subclass deficiency can be a form frust of CID but
there is usually at least a hint of problem with candida or prolonged viral
infection in the history.
Richard Wasserman
Dallas

On Thu, Feb 11, 2016 at 8:23 AM, CIS-PIDD <cis-pidd at lists.clinimmsoc.org>
wrote:

> Good Morning All:
>
> My approach has been to check antibodies to non-live vaccines.  If
> protective, I give VZV vaccine first.  If the patient develops VZV I can
> readily treat it, and I would avoid MMR.  If the patient generates good VZV
> antibody and a positive VZV-specific lymphoproliferative response and no
> symptoms I proceed to MMR.
>
> Joe Church
> Children's Hospital Los Angeles
>
> -----Original Message-----
> From: CIS-PIDD [mailto:cis-pidd at lists.clinimmsoc.org]
> Sent: Thursday, February 11, 2016 4:13 AM
> To: CIS-PIDD
> Subject: [cis-pidd] SPAD and sIgG2+4 deficiency
>
> Dear all,
> I am interested whether there are recommendations on the MMR vaccination
> in patients with specific antibody deficiency or patients with selective
> IgG2+4 deficiency but normal total IgG?
> Best regards,
> Bodo
>
> ****************************************
> Univ.-Prof. Dr. med. B. Grimbacher
>
> Scientific-Director
> CCI-Center for Chronic Immunodeficiency
> UNIVERSITÄTSKLINIKUM FREIBURG
> Tel.: 0761 270-77731  Fax: -77744
> Engesserstraße 4, 79108 Freiburg
> bodo.grimbacher at uniklinik-freiburg.de
> www.uniklinik-freiburg.de/cci
>
> and
>
> Consultant Immunologist
> Institute of Immunity & Transplantation
> Dept of Immunology
> Royal Free Hospital
> UNIVERSITY COLLEGE LONDON
> Pond Street
> London NW3 2QG
> b.grimbacher at ucl.ac.uk
>
> www.centreforimmunodeficiency.com
>
>
>
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-- 
Richard L. Wasserman, MD, PhD
Allergy Partners of North Texas
7777 Forest Lane, Suite B-332
Dallas, Texas 75230
Office (972) 566-7788
Fax (972) 566-8837
Cell (214) 697-7211

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