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Acta Med Port. 2019 Aug 1;32(7-8):514-519. doi: 10.20344/amp.9802. Epub 2019 Aug 1.

[Live Vaccine in Children with DiGeorge/22q11.2 Deletion Syndrome].

[Article in Portuguese; Abstract available in Portuguese from the publisher]

Author information

1
Unidade de Infecciologia Pediátrica. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar de Lisboa Norte. Lisboa. Serviço de Pediatria. Hospital Espírito Santo de Évora. Évora. Portugal.
2
Unidade de Infecciologia Pediátrica. Serviço de Pediatria. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar de Lisboa Norte. Lisboa. Departamento de Pediatria. Centro Hospitalar Baixo Vouga. Aveiro. Portugal.
3
Unidade de Infecciologia Pediátrica. Serviço de Pediatria. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar de Lisboa Norte. Lisboa. Serviço de Imunoalergologia. Centro Hospitalar de Lisboa Norte. Lisboa. Portugal.
4
Centro de Imunodeficiências Primárias. Centro Académico de Medicina de Lisboa. Lisboa. Instituto de Medicina Molecular. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.
5
Unidade de Infecciologia Pediátrica. Serviço de Pediatria. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar de Lisboa Norte. Lisboa. Centro de Imunodeficiências Primárias. Centro Académico de Medicina de Lisboa. Lisboa. Clínica Universitária de Pediatria. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.

Abstract

in English, Portuguese

INTRODUCTION:

Children with DiGeorge syndrome/chromosome 22q11.2 deletion syndrome might have a variable degree of immunodeficiency, which may limit the use of live vaccines. The aim of this study was to review the adverse effects of live vaccines and possible relation with immune status in patients with DiGeorge Syndrome/partial 22q11.2 deletion syndrome.

MATERIAL AND METHODS:

Retrospective study with analysis of the clinical records of children with chromosome 22q11.2 deletion syndrome and DiGeorge syndrome phenotype, followed in a Primary Immunodeficiency center. Data were collected on: demographic characteristics; medical and vaccination history with live vaccines; T-CD4+ lymphocyte counts and lymphocyte proliferative responses to antigens and mitogens; adverse reactions; vaccine failure.

RESULTS:

Twenty three children with DiGeorge syndrome/22q11.2 deletion syndrome were included, 65.2% male, with average age at diagnosis of 11.3 months. Eighteen children (78%) received bacillus Calmette-Guérin vaccine: all with evidence of thymic activity; three presented moderate T-CD4+ lymphopenia and abnormal lymphocyte proliferative responses; one had abnormal lymphocyte proliferative responses for mitogens, four for purified protein derivative and one for tetanus toxoid. Measles, mumps and rubella vaccine was administered to 15 children, three of them with moderate immunosuppression and abnormal lymphocyte proliferative responses. Live attenuated polio vaccine was administered to 4 children without immunosuppression and the rotavirus vaccine to three children, one with moderate immunosuppression. No significant adverse reactions were reported.

DISCUSSION:

These data are in line with the findings of other international studies.

CONCLUSION:

In our sample, live vaccines were well-tolerated, even in children with moderate T-CD4+ lymphopenia and abnormal lymphocyte proliferative responses to antigens/mitogens.

KEYWORDS:

Child; Chromosome Deletion; Chromosome Disorders; Chromosomes, Human, Pair 22; DiGeorge Syndrome; Vaccines, Attenuated/adverse effects; Viral Vaccines/adverse effects

PMID:
31445531
DOI:
10.20344/amp.9802
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