학술논문
Stem Cell Transplant in Immune-deficiency–associated Vaccine-derived Poliovirus.
Document Type
Case Study
Author
Ranchod, Heena; Howard, Wayne; Roux, Adele; Zyl, Walda van; Ekermans, Pieter; van den Berg, Sylvia; Seakamela, Lerato; Makua, Koketso; Yousif, Mukhlid; Sibiya, Rosinah; Plessis, Heleen Du; Phalane, Emmanuel; McCarthy, Kerrigan; Moonsamy, Shelina; Reynders, David; Hincks, Jeffrey; Suchard, Melinda S; Plessis, Nicolette M du
Source
Subject
*STEM cell transplantation
*POLIO
*POLIOVIRUS
*SEVERE combined immunodeficiency
*INTRAVENOUS immunoglobulins
*PRIMARY immunodeficiency diseases
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Language
ISSN
2328-8957
Abstract
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. [ABSTRACT FROM AUTHOR]