Report #2879515

Overview

Sex

Male

Age

Age unknown

State

MA

Recovered

Unknown

Vaccinated

—

Onset

—

Days to onset

—

Hospital days

—

Symptoms (9)

Symptom narrative

absent antibody responses to childhood pneumococcal, hib, diphteria vaccines; Literature Report: This literature report has been received from the authors of a published literature article, entitled as stated above, referring to a 17-year-old male. The patient's medical three episodes of lip swelling and respiratory symptoms requiring epinephrine/anaphylaxis of unclear cause (also reported as idiopathic anaphylaxis, include unknown cause such stinging insects foods or medications); outgrew eczema, recurrent ear infections, strep throat infection, strep throat infection, tonsillectomy, adenoidectomy, staphylococcal abscesses, impetigo, molluscum infection, two pneumonias, history of recurrent sinopulmonary and skin infections, and history of recurrent sinopulmonary and skin infections. The patient's concurrent conditions included well controlled persistent asthma, allergic rhinitis/conjunctivitis, atopic disease, MGUS, Immunodeficiency specifically hyper IgM syndrome, and combined immunodeficiency (CID). Concomitant therapies were not reported. The patient had not been hospitalized for infections. On an unknown date, the patient when child was vaccinated with pneumococcal vaccine (manufacturer unknown), hib and diphtheria vaccine (manufacturer unknown) as prophylaxis (formulations, doses, vaccines schemes, routes, anatomical locations of vaccination, lot numbers and expiration dates were not provided). On an unknown date, laboratory findings included: normal tryptase, normal IgE, low IgG, high IgM and IgA; and monoclonal lambda peak. Flowcytometry showed increased naive T and B Cells, decreased memory B cells, decreased memory and effector T cells. He had absent antibody responses to childhood pneumococcal vaccine (manufacturer unknown), Hib and diphtheria vaccine (manufacturer unknown). After vaccine booster doses, repeated tetanus titer was protective, but post-vaccine titers to Hib and S. pneumoniae remained absent. Also, it was reported that a primary immunodeficiency gene panel revealed a variant of unknown significance in CARD11, this was thought to be clinically significant. The outcome of the event was not provided. The causality assessment between the event and vaccines was related. Lot # is being requested and will be submitted if received. A copy of the published article is attached as further documentation of the patient's experience.

Current illness

Allergic rhinoconjunctivitis; Asthma; Atopic; Combined immunodeficiency; Hyper IgM syndrome; MGUS

Medical history

Medical History/Concurrent Conditions: Adenoidectomy; Anaphylaxis (History of three episodes of lip swelling and respiratory symptoms requiring epinephrine/anaphylaxis of unclear cause); Ear infection; Eczema; Impetigo; Molluscum contagiosum virus infection; Pneumonia; Sinus infection; Skin infection NOS; Staphylococcal abscess; Streptococcal infection; Throat infection; Tonsillectomy

Lab data

Test Name: tryptase; Result Unstructured Data: normal; Test Name: IgE; Result Unstructured Data: normal; Test Name: IgG; Result Unstructured Data: low; Test Name: IgM; Result Unstructured Data: high; Test Name: IgA; Result Unstructured Data: high; Test Name: monoclonal lambda; Result Unstructured Data: peak; Test Name: flow cytometry; Result Unstructured Data: Showed increased naive T and B Cells, decreased memory B cells, decreased memory and effector T cells.; Test Name: antibody; Result Unstructured Data: absent response to childhood pneumococcal, HiB and diphtheria vaccines; Test Name: repated titer post vaccine; Result Unstructured Data: after vaccine booster doses, repeated tetanus titer was protective, but post-vaccine titers to Hib and S. pneumoniae remained absent.; Test Name: immunodeficiency gene panel; Result Unstructured Data: revealed a variant of unknown significance in CARD11, was thought to be clinically significant