[CIS PIDD] [cis-pidd] XLT and MMR/Varicella Vaccination

Fri Apr 13 12:28:23 EDT 2018

I agree with Joe. You could also check if he makes T cell proliferative responses to Tetanus before proceeding with the first VZV.

Manish

On Apr 13, 2018 9:23 AM, CIS-PIDD <cis-pidd at lists.clinimmsoc.org> wrote:

Eleanora:

I’m conservative with these types of patients.

I would check to see if the patient made specific antibodies to tetanus toxoid and Hib.

If he did, I would then give VZV first.

If he breaks out in florid varicella you can treat with acyclovir, but I would be hesitant to give MMR.

If he tolerates VZV then 1 month later give MMR.

Good luck.

Joe Church

Children’s Hospital Los Angeles

From: cis-pidd at lyris.dundee.net [mailto:cis-pidd at lyris.dundee.net] On Behalf Of CIS-PIDD
Sent: Friday, April 13, 2018 9:10 AM
To: CIS-PIDD
Subject: [cis-pidd] XLT and MMR/Varicella Vaccination (EXTERNAL EMAIL)

Dear all,

I would like your advice regarding a patient just diagnosed with XLT (WAS mut. V332A). He presented with hiatal hernia and he underwent surgery shortly after birth. Afterwards he developed persistent mild lymphadenopathy (LC and inguinal), reason why he came to our attention. Common infectious diseases were excluded. He suffers from some mild eczema, he has IgE of 494 kU/L with egg specific IgE. He also has small platelet volume, but not thrombocytopenia so far. His lympho subsets are normal as well as immunoglobulin values.

We run a gene panel and we fund a mutation on WAS gene compatible with XLT. Lymphadenopathy progressively solved. He never had major infections and he doing well.

He is now 15 m/o and he needs to undertake MMR/Varicella vaccination. What would you suggest to do?

Looking forward your inputs!

Best wishes

Eleonora

——————————————————————————————————————

Eleonora Gambineri, MD
Researcher/Assistant Professor

Department of "NEUROFARBA": Section of Child's Health
University of Florence

Department of Haematology-Oncology: BMT Unit
"Anna Meyer" Children's Hospital

Viale Gaetano Pieraccini,24
50139 FIRENZE
ITALY
Tel +39 055 5662405 (office)/055 5662738(BMT ward)
Fax +39 055 4221012
e-mail: eleonora.gambineri at unifi.it<mailto:eleonora.gambineri at unifi.it>; e.gambineri at meyer.it<mailto:e.gambineri at meyer.it>

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Eleanora:

I’m conservative with these types of patients.

I would check to see if the patient made specific antibodies to tetanus toxoid and Hib.
If he did, I would then give VZV first.
If he breaks out in florid varicella you can treat with acyclovir, but I would be hesitant to give MMR.
If he tolerates VZV then 1 month later give MMR.

Good luck.

Joe Church
Children’s Hospital Los Angeles

From: cis-pidd at lyris.dundee.net [mailto:cis-pidd at lyris.dundee.net] On Behalf Of CIS-PIDD
Sent: Friday, April 13, 2018 9:10 AM
To: CIS-PIDD
Subject: [cis-pidd] XLT and MMR/Varicella Vaccination (EXTERNAL EMAIL)

Dear all,

I would like your advice regarding a patient just diagnosed with XLT (WAS mut. V332A). He presented with hiatal hernia and he underwent surgery shortly after birth. Afterwards he developed persistent mild lymphadenopathy (LC and inguinal), reason why he came to our attention. Common infectious diseases were excluded. He suffers from some mild eczema, he has IgE of 494 kU/L with egg specific IgE. He also has small platelet volume, but not thrombocytopenia so far. His lympho subsets are normal as well as immunoglobulin values.
We run a gene panel and we fund a mutation on WAS gene compatible with XLT. Lymphadenopathy progressively solved. He never had major infections and he doing well.
He is now 15 m/o and he needs to undertake MMR/Varicella vaccination. What would you suggest to do?

Looking forward your inputs!

Best wishes
Eleonora

——————————————————————————————————————
Eleonora Gambineri, MD
Researcher/Assistant Professor

Department of "NEUROFARBA": Section of Child's Health
University of Florence

Department of Haematology-Oncology: BMT Unit
"Anna Meyer" Children's Hospital

Viale Gaetano Pieraccini,24
50139 FIRENZE
ITALY
Tel +39 055 5662405 (office)/055 5662738(BMT ward)
Fax +39 055 4221012
e-mail: eleonora.gambineri at unifi.it<mailto:eleonora.gambineri at unifi.it>; e.gambineri at meyer.it<mailto:e.gambineri at meyer.it>
——————————————————————————————————————

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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.

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or send a blank email to leave-4858734-102983943.a6ff2564f5039cf916b988f253ff1aea at lyris.dundee.net<mailto:leave-4858734-102983943.a6ff2564f5039cf916b988f253ff1aea at lyris.dundee.net>

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