Stem Cell Transplant in Immune-deficiency-associated Vaccine-derived Poliovirus

被引：0

作者：

Ranchod, Heena ^{[1
,2
,10
]}

Howard, Wayne ^{[1
,2
]}

Roux, Adele ^{[3
]}

van Zyl, Walda ^{[4
]}

Ekermans, Pieter ^{[5
]}

van den Berg, Sylvia ^{[6
]}

Seakamela, Lerato ^{[1
]}

Makua, Koketso ^{[1
]}

Yousif, Mukhlid ^{[1
,7
]}

Sibiya, Rosinah ^{[1
]}

Du Plessis, Heleen ^{[1
]}

Phalane, Emmanuel ^{[1
,7
]}

Mccarthy, Kerrigan ^{[1
]}

Moonsamy, Shelina ^{[1
]}

Reynders, David ^{[8
]}

Hincks, Jeffrey ^{[9
]}

Suchard, Melinda S. ^{[1
,2
]}

du Plessis, Nicolette M. ^{[8
]}

机构：

[1] Natl Inst Communicable Dis, Ctr Vaccines & Immunol, Johannesburg, South Africa

[2] Univ Witwatersrand, Fac Hlth Sci, Sch Pathol, Dept Chem Pathol, Johannesburg, South Africa

[3] Life Groenkloof Hosp, Pretoria, South Africa

[4] Univ Pretoria, Fac Hlth Sci, Dept Med Virol, Natl Hlth Lab Serv,Tshwane Acad Div, Pretoria, South Africa

[5] Ampath Labs, Dept Med Microbiol, Pretoria, South Africa

[6] Ampath Labs, Dept Immunol, Pretoria, South Africa

[7] Univ Witwatersrand, Fac Hlth Sci, Sch Pathol, Dept Virol, Johannesburg, South Africa

[8] Univ Pretoria, Fac Hlth Sci, Dept Paediat, Pretoria, South Africa

[9] ViroDefense, Chevy Chase, MD USA

[10] Univ Witwatersrand, Wits Med Sch, Dept Chem Pathol, 7 York Rd, ZA-2193 Johannesburg, South Africa

来源：

OPEN FORUM INFECTIOUS DISEASES | 2024年 / 11卷 / 02期

关键词：

acute flaccid paralysis; disseminated BCG; immunodeficiency; intravenous immune globulin; IRIS; iVDPV; pocapavir; polio; poliomyelitis; RAG; SCID; stem cell transplant; transplant; vaccine-associated; vaccine-derived poliovirus; VAPP; IMMUNODEFICIENCY; ENTEROVIRUS; TYPE-3;

D O I：

10.1093/ofid/ofad678

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Patients with severe primary immunodeficiency are at risk for complications from live-attenuated vaccines. Here, we report a case of a vaccine-associated paralytic polio and Bacille Calmette-Guerin disease in a 6-month-old girl with severe combined immunodeficiency resulting from homozygous recombinant activating gene 1 deficiency. The patient was successfully treated with intravenous immunoglobulins and oral pocapavir for poliovirus, and antimycobacterial therapy for regional Bacille Calmette-Guerin disease, allowing stem cell transplant. Following transplantation, poliovirus type 3 with 13 mutations was detected from cerebrospinal fluid but not from stool, indicating ongoing viral evolution in the central nervous system despite pocapavir treatment. Clinical improvement and immune reconstitution allowed the patient to be successfully discharged with no further detection of poliovirus.

引用

页数：5

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