Evaluation of patients with primary immunodeficiency associated with Bacille Calmette-Guerin (BCG)-vaccine-derived complications,Allergologia et Immunopathologia

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Evaluation of patients with primary immunodeficiency associated with Bacille Calmette-Guerin (BCG)-vaccine-derived complications
Allergologia et Immunopathologia ( IF 2.5 ) Pub Date : 2020-10-25 , DOI: 10.1016/j.aller.2020.04.004
M Sohani ₁ , S Habibi ₁ , S Delavari ₁ , S Shahkarami ₂ , Reza Yazdani ₃ , P Shirmast ₁ , F Nazari ₁ , T Moeini Shad ₁ , S Mamishi ₄ , G Azizi ₅ , A U Anka ₆ , G Hassanpour ₇ , A Kalantari ₈ , M Shariat ₉ , A Shafiei ₁₀ , H Abolhassani ₁₁ , A Aghamohammadi ₃

Affiliation

Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran, and the University of Medical Science, Tehran, Iran.
Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran, and the University of Medical Science, Tehran, Iran; Medical Genetics Network (Megene), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center, Tehran, and the University of Medical Science, Tehran, Iran; Iranian Primary Immunodeficiencies Network (IPIN), Tehran University of Medical Sciences, Tehran, Iran.
Pediatric Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
Department of Medical Laboratory Science, College of Medical Sciences, Ahmadu Bello University, Zaria, Nigeria.
Center for Research of Endemic Parasites of Iran, Tehran University of Medical Sciences, Tehran, Iran.
Department of Immunology and Allergy, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Allergy and Clinical Immunology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
The Department of Immunology, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Research Center for Primary Immunodeficiencies, Iran University of medical sciences, Tehran, Iran; Division of Clinical Immunology, Department of Laboratory Medicine, Karolinska Institute at Karolinska University Hospital Huddinge, Stockholm, Sweden.

Background

Bacille Calmette-Guerin (BCG) vaccination has a great impact on the prevention of severe complications of tuberculosis. However, in patients with primary immunodeficiencies (PID), it can lead to severe complications such as severe combined immunodeficiency, chronic granulomatous disease, and Mendelian susceptibility to mycobacterial disease. This study highlights the demographics, clinical complications and laboratory parameters among PID patients associated with BCG vaccination side effects.

Methods

One hundred and thirty-seven PID patients with BCGosis were evaluated in this study, based on the complications following BCG vaccination.

Results

The mean age of the patients with BCG complications at the time of the first visit was five years. The within-group comparison of patients showed a highly significant incidence of pneumonia and hepatomegaly in severe combined immunodeficiency patients. Furthermore, the immunologic data showed an increase in the overall rates of lymphocytes such as CD3+, CD4+ and CD8 + T cells in Mendelian susceptibility to mycobacterial disease patients. The level of immunoglobulins has also increased in chronic granulomatous disease patients.

Conclusion

The high rate of undiagnosed PIDs predisposes individuals to a high risk of severe side effects as a result of BCG vaccination, as well as infants that are less than one month of age. Therefore, there is a need for early screening and diagnosis of PIDs before exposing unknown PID status patients to BCG vaccination. The benefits of screening and early diagnosis of PID cannot be overemphasized, especially in patients with a previous family history of immunodeficiency.

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