Received Mar 5, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| PPV | PNEUMO (NO BRAND NAME) | UNKNOWN MANUFACTURER | UNK | — | — |
| PPV | PNEUMO (NO BRAND NAME) | UNKNOWN MANUFACTURER | UNK | — | — |
| UNK | VACCINE NOT SPECIFIED (NO BRAND NAME) | UNKNOWN MANUFACTURER | UNK | — | — |
Despite prior pneumococcal vaccination, her response was inadequate as evident by low pneumococcal Ab levels.; Literature Report: This literature marketed report has been received from the authors of a published literature article, titled as stated above and refers to a 75-year-old woman with end-stage renal disease (due to adult polycystic disease (APKD)) status post kidney transplant. Her immunosuppressive regimen included mycophenolate, tacrolimus, and prednisone, with recent addition of inhaled tobramycin. On an unknown date, the patient was vaccinated with unspecified pneumococcal vaccine (manufacturer unknown) (dose, route of administration, anatomical location, lot # and expiration date were not provided), for prophylaxis. On an unknown date, she presented to the Immunology clinic for evaluation of recurrent infections (Candida, Haemophilus, Mycobacterium Avium Complex, and Pseudomonas aeruginosa). She recently developed pseudomonas lung colonization. Despite prior pneumococcal vaccination, her response was inadequate as evident by low pneumococcal antibody (Ab) levels (Vaccination failure). Laboratory testing showed white blood cell (WBC) 8.1 (unit not provided), hemoglobin (Hgb) 15.3, normal CD3, CD4, CD8 Cells, CD4/CD8 ratio slightly low, and slightly low natural killer (NK) cells. Serum Immunoglobulin levels were immunoglobulin G (IgG) 962 mg/dl, immunoglobulin A (IgA) 174 mg/dl, immunoglobulin M (IgM) 155 mg/dl and immunoglobulin E (IgE) 2 IU/ml. CD19 count: low, 0% total 3 cells per HPF. Given her stable allograft function and reluctance to alter her immunosuppression, she was offered intravenous immunoglobulin (IVIG) therapy to prevent further pneumonia exacerbations and hospitalizations. A copy of the published article is attached as further documentation of the patient's experience.
Candida infection; End stage renal disease; Haemophilus infection; Infection Pseudomonas aeruginosa; Mycobacterium avium complex infection recurrent; Polycystic kidney
Medical History/Concurrent Conditions: Kidney transplant
tacrolimus; prednisone; tobramycin; mycophenolate
Test Name: IgG; Test Result: 962 mg/dl; Result Unstructured Data: 962 mg/dL; Test Name: Immunoglobulin A; Test Result: 174 mg/dl; Result Unstructured Data: 174 mg/dL; Test Name: Immunoglobulin M; Result Unstructured Data: 155 mg/dL 155 mg/mL; Test Name: immunoglobulin E; Result Unstructured Data: 2 IU/ml 2 [iU]/mL; Test Name: pneumococcal Ab levels; Result Unstructured Data: low levels; Test Name: CD3; Result Unstructured Data: normal; Test Name: CD4; Result Unstructured Data: normal; Test Name: CD8; Result Unstructured Data: normal; Test Name: CD4/CD8 ratio; Result Unstructured Data: slightly low; Test Name: NK cells; Result Unstructured Data: slightly low; Test Name: CD19 count; Result Unstructured Data: low, 0% total 3 cells per high power field (HPF); Test Name: WBC; Result Unstructured Data: 8.1 (units not provided); Test Name: Hgb; Result Unstructured Data: 15.3 (unit not provided)