Adverse Events of the BCG (Bacillus Calmette–Guérin) and Rotavirus Vaccines in a Young Infant with Inborn Error of Immunity
Background. The Bacillus Calmette–Guérin (BCG) and rotavirus vaccines are live-attenuated preparations. In the United Arab Emirates, these products are universally administered to the young infants. This unguided practice does not account for the children with immunodeficiency, which frequently mani...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Immunology |
| Online Access: | http://dx.doi.org/10.1155/2020/8857152 |
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| author | Suleiman Al-Hammadi Najla S. Alkuwaiti Ghassan A. Ghatasheh Huda Al Dhanhani Hiba M. Shendi Abdulghani S. Elomami Farida Almarzooqi Abdul-Kader Souid |
| author_facet | Suleiman Al-Hammadi Najla S. Alkuwaiti Ghassan A. Ghatasheh Huda Al Dhanhani Hiba M. Shendi Abdulghani S. Elomami Farida Almarzooqi Abdul-Kader Souid |
| author_sort | Suleiman Al-Hammadi |
| collection | DOAJ |
| description | Background. The Bacillus Calmette–Guérin (BCG) and rotavirus vaccines are live-attenuated preparations. In the United Arab Emirates, these products are universally administered to the young infants. This unguided practice does not account for the children with immunodeficiency, which frequently manifests after the administration of these vaccines. We present here a young infant with immunodeficiency that developed disseminated tuberculosis infection and severe diarrhea due to these improper immunizations. Case Presentation. This young infant was diagnosed at six months of age with “immunodeficiency type 19” (MIM#615617) due to homozygous nonsense variant, NM_000732.4 (CD3D):c.128G > A, p.Trp43∗ (variation ClinVar#VCV000643120.1; pathogenic). This variant creates premature stop-gain in CD3D (CD3 antigen, delta subunit, autosomal recessive; MIM#186790), resulting in loss-of-function. He also had “X-linked agammaglobulinemia” (MIM#300755) due to hemizygous missense variant, NM_001287344.1 (BTK):c.80G > A, p.Gly27Asp (novel). He had a sibling who passed away in infancy of unknown disease and family members with autoimmune disorders. Despite these clear clues, he was immunized with BCG at birth and rotavirus at 2 and 4 months. He was well in the first four months. He then developed high-fever, lymphadenopathy, and refractory diarrhea. Stool was positive for rotavirus, and lymph node biopsy showed acid-fast bacilli, consistent with tuberculosis lymphadenitis. These infections were serious and markedly complicated his clinical course, which included bone marrow transplantation from a matched sibling. Conclusions. These unfortunate events could have been avoided by compiling the available clinical information. This patient underscores the importance of implementing proper policies for BCG and rotavirus vaccinations. International registries of adverse events of universally administered vaccines are crucial. |
| format | Article |
| id | doaj-art-21a8ca0ede9542f7adf719a4fba2aa03 |
| institution | Kabale University |
| issn | 2090-6609 2090-6617 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Immunology |
| spelling | doaj-art-21a8ca0ede9542f7adf719a4fba2aa032025-02-03T01:00:11ZengWileyCase Reports in Immunology2090-66092090-66172020-01-01202010.1155/2020/88571528857152Adverse Events of the BCG (Bacillus Calmette–Guérin) and Rotavirus Vaccines in a Young Infant with Inborn Error of ImmunitySuleiman Al-Hammadi0Najla S. Alkuwaiti1Ghassan A. Ghatasheh2Huda Al Dhanhani3Hiba M. Shendi4Abdulghani S. Elomami5Farida Almarzooqi6Abdul-Kader Souid7Department of Pediatrics, College of Medicine and Health Sciences, UAE University, Abu Dhabi, UAEDepartment of Pediatrics, Tawam Hospital, Alain, Abu Dhabi, UAEDepartment of Pediatrics, Tawam Hospital, Alain, Abu Dhabi, UAEDepartment of Pediatrics, Tawam Hospital, Alain, Abu Dhabi, UAEDepartment of Pediatrics, Tawam Hospital, Alain, Abu Dhabi, UAEDepartment of Pathology, Tawam Hospital, Alain, Abu Dhabi, UAEDepartment of Pediatrics, College of Medicine and Health Sciences, UAE University, Abu Dhabi, UAEDepartment of Pediatrics, College of Medicine and Health Sciences, UAE University, Abu Dhabi, UAEBackground. The Bacillus Calmette–Guérin (BCG) and rotavirus vaccines are live-attenuated preparations. In the United Arab Emirates, these products are universally administered to the young infants. This unguided practice does not account for the children with immunodeficiency, which frequently manifests after the administration of these vaccines. We present here a young infant with immunodeficiency that developed disseminated tuberculosis infection and severe diarrhea due to these improper immunizations. Case Presentation. This young infant was diagnosed at six months of age with “immunodeficiency type 19” (MIM#615617) due to homozygous nonsense variant, NM_000732.4 (CD3D):c.128G > A, p.Trp43∗ (variation ClinVar#VCV000643120.1; pathogenic). This variant creates premature stop-gain in CD3D (CD3 antigen, delta subunit, autosomal recessive; MIM#186790), resulting in loss-of-function. He also had “X-linked agammaglobulinemia” (MIM#300755) due to hemizygous missense variant, NM_001287344.1 (BTK):c.80G > A, p.Gly27Asp (novel). He had a sibling who passed away in infancy of unknown disease and family members with autoimmune disorders. Despite these clear clues, he was immunized with BCG at birth and rotavirus at 2 and 4 months. He was well in the first four months. He then developed high-fever, lymphadenopathy, and refractory diarrhea. Stool was positive for rotavirus, and lymph node biopsy showed acid-fast bacilli, consistent with tuberculosis lymphadenitis. These infections were serious and markedly complicated his clinical course, which included bone marrow transplantation from a matched sibling. Conclusions. These unfortunate events could have been avoided by compiling the available clinical information. This patient underscores the importance of implementing proper policies for BCG and rotavirus vaccinations. International registries of adverse events of universally administered vaccines are crucial.http://dx.doi.org/10.1155/2020/8857152 |
| spellingShingle | Suleiman Al-Hammadi Najla S. Alkuwaiti Ghassan A. Ghatasheh Huda Al Dhanhani Hiba M. Shendi Abdulghani S. Elomami Farida Almarzooqi Abdul-Kader Souid Adverse Events of the BCG (Bacillus Calmette–Guérin) and Rotavirus Vaccines in a Young Infant with Inborn Error of Immunity Case Reports in Immunology |
| title | Adverse Events of the BCG (Bacillus Calmette–Guérin) and Rotavirus Vaccines in a Young Infant with Inborn Error of Immunity |
| title_full | Adverse Events of the BCG (Bacillus Calmette–Guérin) and Rotavirus Vaccines in a Young Infant with Inborn Error of Immunity |
| title_fullStr | Adverse Events of the BCG (Bacillus Calmette–Guérin) and Rotavirus Vaccines in a Young Infant with Inborn Error of Immunity |
| title_full_unstemmed | Adverse Events of the BCG (Bacillus Calmette–Guérin) and Rotavirus Vaccines in a Young Infant with Inborn Error of Immunity |
| title_short | Adverse Events of the BCG (Bacillus Calmette–Guérin) and Rotavirus Vaccines in a Young Infant with Inborn Error of Immunity |
| title_sort | adverse events of the bcg bacillus calmette guerin and rotavirus vaccines in a young infant with inborn error of immunity |
| url | http://dx.doi.org/10.1155/2020/8857152 |
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