[CIS PIDD] [cis-pidd] 5yo PCD + SAD

[CIS-PIDD]

Colleagues:

I follow a 5yo boy with genetically-documented primary ciliary dyskinesia (PCD) and selective antibody deficiency (SAD).  He has chronic bronchitis and otitis media.  The infecting organisms have not been identified.  The association of PCD and humoral immunodeficiency has been reported previously (Respiratory Medicine 2014;108:931-934).

My patient has an elevated IgG (1260mg/dL) and responded well to tetanus and Hib vaccines.  However, he generated >1.3mcg/mL of antibody to only 8 of 23 serotypes tested after Pneumovax.  Because of potential community exposure and the availability of effective anti-viral therapy, I administered Varicella-Zoster vaccine.  He tolerated this well and generated excellent antibody and a vigorous VZV-specific lymphoproliferative response.

My question is should I give him MMR vaccine - live attenuated viruses and no therapy if he gets measles, mumps or rubella from the vaccine?

Joe Church
Children's Hospital Los Angeles






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