Saltar al contenido
Merck

Invasive pneumococcal disease in children can reveal a primary immunodeficiency.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2014-04-25)
Jean Gaschignard, Corinne Levy, Maya Chrabieh, Bertrand Boisson, Cécile Bost-Bru, Stéphane Dauger, François Dubos, Philippe Durand, Joël Gaudelus, Dominique Gendrel, Christèle Gras Le Guen, Emmanuel Grimprel, Gaël Guyon, Catherine Jeudy, Eric Jeziorski, Francis Leclerc, Pierre-Louis Léger, Fabrice Lesage, Mathie Lorrot, Isabelle Pellier, Didier Pinquier, Loïc de Pontual, Philippe Sachs, Caroline Thomas, Pierre Tissières, Frédéric V Valla, Philippe Desprez, Véronique Frémeaux-Bacchi, Emmanuelle Varon, Xavier Bossuyt, Robert Cohen, Laurent Abel, Jean-Laurent Casanova, Anne Puel, Capucine Picard
RESUMEN

About 10% of pediatric patients with invasive pneumococcal disease (IPD) die from the disease. Some primary immunodeficiencies (PIDs) are known to confer predisposition to IPD. However, a systematic search for these PIDs has never been carried out in children presenting with IPD. We prospectively identified pediatric cases of IPD requiring hospitalization between 2005 and 2011 in 28 pediatric wards throughout France. IPD was defined as a positive pneumococcal culture, polymerase chain reaction result, and/or soluble antigen detection at a normally sterile site. The immunological assessment included abdominal ultrasound, whole-blood counts and smears, determinations of plasma immunoglobulin and complement levels, and the evaluation of proinflammatory cytokines. We included 163 children with IPD (male-to-female ratio, 1.3; median age, 13 months). Seventeen children had recurrent IPD. Meningitis was the most frequent type of infection (87%); other infections included pleuropneumonitis, isolated bloodstream infection, osteomyelitis, endocarditis, and mastoiditis. One patient with recurrent meningitis had a congenital cerebrospinal fluid fistula. The results of immunological explorations were abnormal in 26 children (16%), and a PID was identified in 17 patients (10%), including 1 case of MyD88 deficiency, 3 of complement fraction C2 or C3 deficiencies, 1 of isolated congenital asplenia, and 2 of Bruton disease (X-linked agammaglobulinemia). The proportion of PIDs was much higher in children aged >2 years than in younger children (26% vs 3%; P < .001). Children with IPD should undergo immunological investigations, particularly those aged >2 years, as PIDs may be discovered in up to 26% of cases.

MATERIALES
Referencia del producto
Marca
Descripción del producto

Sigma-Aldrich
Mouse IL-6 ELISA Kit, for serum, plasma and cell culture supernatant
Sigma-Aldrich
Rat IL-6 ELISA Kit, for serum, plasma and cell culture supernatants
Sigma-Aldrich
Mouse IL-6 ELISA Kit, for cell and tissue lysates
Sigma-Aldrich
Rat Interleukin-6 ELISA Kit, for for cell lysate and tissue lysate
Sigma-Aldrich
Mouse IL-6 R ELISA Kit, for serum, plasma and cell culture supernatant