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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  

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.



中文翻译:

与卡介苗 (BCG) 疫苗衍生并发症相关的原发性免疫缺陷患者的评估

背景

卡介苗 (BCG) 疫苗接种对预防结核病严重并发症有很大影响。然而,在原发性免疫缺陷(PID)患者中,它可能导致严重的并发症,如严重的联合免疫缺陷、慢性肉芽肿病和对分枝杆菌病的孟德尔易感性。这项研究强调了与 BCG 疫苗接种副作用相关的 PID 患者的人口统计学、临床并发症和实验室参数。

方法

本研究根据卡介苗接种后的并发症评估了 137 名患有卡介苗的 PID 患者。

结果

第一次就诊时有 BCG 并发症的患者的平均年龄为 5 岁。患者的组内比较显示重症联合免疫缺陷患者肺炎和肝肿大的发生率非常显着。此外,免疫学数据显示,在分枝杆菌病孟德尔易感性患者中,淋巴细胞(如 CD3+、CD4+ 和 CD8+ T 细胞)的总体比率增加。慢性肉芽肿病患者的免疫球蛋白水平也有所增加。

结论

未确诊 PID 的高比率使个人以及不到 1 个月大的婴儿因接种 BCG 疫苗而容易出现严重副作用的高风险。因此,在将未知 PID 状态的患者暴露于 BCG 疫苗接种之前,需要对 PID 进行早期筛查和诊断。PID 筛查和早期诊断的好处怎么强调都不为过,尤其是对于既往有免疫缺陷家族史的患者。

更新日期:2020-11-27
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