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

[CIS-PIDD]

We routinely give MMR to all of these kids.  Even in normal hosts the incidence of rash is nearly 5%.

We even give MMR to our 22q11 deletion children as long as the CD4 count is over 400.

Lisa


Lisa Kobrynski, MD, MPH
Associate Professor of Pediatrics
Marcus Professor of Immunology
Section, Allergy/Immunology
________________________________
From: CIS-PIDD <cis-pidd at lists.clinimmsoc.org>
Sent: Tuesday, September 20, 2016 9:33:31 PM
To: CIS-PIDD
Subject: [cis-pidd] 5yo PCD + SAD

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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