[CIS PIDD] [cis-pidd] varicella vaccination in T cell lymphopenia

[CIS-PIDD]

Dear all, 

I would very much appreciate ypur suggestions regarding this patient:

-5 yo caucasian male born to non-consanguineous parents, with severe T lymphopenia (ALC between 900-1200/mm3 over time) detected in the postoperative of cardiovascular surgery (congenital heart disease) at the age of 2 months. No severe infections previous to the first evaluation. Normal T cell counts at birth. No dysmorphic features. Normal IgG, IgA and IgM at diagnosis. Normal monocyte, neutrophil, eos and basophils. Normal Hb and platelets. No protein-lose enteropathy. Was started on IVIG and antibiotic prophylaxis, while completing the study. 

T cell subphenotyping shows: 
CD3+: 28%
CD4+: 16,2% (178/mm3)
CD8+: 9,5% (105/mm3)
CD19+: 55,2% (607/mm3)
CD16-56+: 15,9% (175/mm3)

CD3+ alpha/beta: 84,8% (264/mm3)
CD3 gamma/delta: 14% (43,6%)
CD3+CD45RA+: 33,6%
CD3+CD45RO+: 52,1%

with normal prolipherative responses to PHA. No deletion in 2q112 nor in 10q11. Truesight gene panel shows no mutations. 

Has been withdrawn of IVIG, and shows normal IgG, IgA, IgM and normal vaccine responses to inactivated vaccines. 

How would you manage the risk of varicella, since VVZ vaccine should not be administered? 



Thank you in advance, 



Laia Alsina, MD, PhD
Attending at the Allergy and Clinical Immunology Department
Hospital Sant Joan de Déu, Barcelona
Immunology Unit, Hospital Sant Joan de Déu-Hospital Clínic.
ORCID ID: http://orcid.org/0000-0002-3559-0018






---
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=4064346
or send a blank email to leave-4064346-96396833.5a9591ccd1e327fe6bc4d1543298c482 at lyris.dundee.net