Open forum infectious diseases · 2024
Stem Cell Transplant in Immune-deficiency-associated Vaccine-derived Poliovirus.
СтатьяНазвание и аннотация: Перевод в очереди
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Ranchod Heena, Howard Wayne, Roux Adele, van Zyl Walda, Ekermans Pieter, van den Berg Sylvia, Seakamela Lerato, Makua Koketso, Yousif Mukhlid, Sibiya Rosinah, Du Plessis Heleen, Phalane Emmanuel, McCarthy Kerrigan, Moonsamy Shelina, Reynders David, Hincks Jeffrey, Suchard Melinda S, du Plessis Nicolette M
Аннотация
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-Guérin 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-Guérin 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.