ABSTRACT
BACKGROUND: Bacille Calmette-Guerin (BCG) vaccination has a great impact on the prevention of severe complications of tuberculosis. However, in patients with primary immunodeficiencies (PID), it can lead to severe complications such as severe combined immunodeficiency, chronic granulomatous disease, and Mendelian susceptibility to mycobacterial disease. This study highlights the demographics, clinical complications and laboratory parameters among PID patients associated with BCG vaccination side effects. METHODS: One hundred and thirty-seven PID patients with BCGosis were evaluated in this study, based on the complications following BCG vaccination. RESULTS: The mean age of the patients with BCG complications at the time of the first visit was five years. The within-group comparison of patients showed a highly significant incidence of pneumonia and hepatomegaly in severe combined immunodeficiency patients. Furthermore, the immunologic data showed an increase in the overall rates of lymphocytes such as CD3+, CD4+ and CD8 + T cells in Mendelian susceptibility to mycobacterial disease patients. The level of immunoglobulins has also increased in chronic granulomatous disease patients. CONCLUSION: The high rate of undiagnosed PIDs predisposes individuals to a high risk of severe side effects as a result of BCG vaccination, as well as infants that are less than one month of age. Therefore, there is a need for early screening and diagnosis of PIDs before exposing unknown PID status patients to BCG vaccination. The benefits of screening and early diagnosis of PID cannot be overemphasized, especially in patients with a previous family history of immunodeficiency
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Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , BCG Vaccine/adverse effects , Immunologic Deficiency Syndromes/chemically induced , Risk Factors , Age Factors , Statistics, Nonparametric , Immunologic Deficiency Syndromes/mortality , Time Factors , Early Diagnosis , Iran/epidemiologyABSTRACT
BACKGROUND: Bacille Calmette-Guerin (BCG) vaccination has a great impact on the prevention of severe complications of tuberculosis. However, in patients with primary immunodeficiencies (PID), it can lead to severe complications such as severe combined immunodeficiency, chronic granulomatous disease, and Mendelian susceptibility to mycobacterial disease. This study highlights the demographics, clinical complications and laboratory parameters among PID patients associated with BCG vaccination side effects. METHODS: One hundred and thirty-seven PID patients with BCGosis were evaluated in this study, based on the complications following BCG vaccination. RESULTS: The mean age of the patients with BCG complications at the time of the first visit was five years. The within-group comparison of patients showed a highly significant incidence of pneumonia and hepatomegaly in severe combined immunodeficiency patients. Furthermore, the immunologic data showed an increase in the overall rates of lymphocytes such as CD3+, CD4+ and CD8â¯+â¯T cells in Mendelian susceptibility to mycobacterial disease patients. The level of immunoglobulins has also increased in chronic granulomatous disease patients. CONCLUSION: The high rate of undiagnosed PIDs predisposes individuals to a high risk of severe side effects as a result of BCG vaccination, as well as infants that are less than one month of age. Therefore, there is a need for early screening and diagnosis of PIDs before exposing unknown PID status patients to BCG vaccination. The benefits of screening and early diagnosis of PID cannot be overemphasized, especially in patients with a previous family history of immunodeficiency.
Subject(s)
BCG Vaccine/adverse effects , Granulomatous Disease, Chronic/epidemiology , Primary Immunodeficiency Diseases/diagnosis , Adolescent , BCG Vaccine/immunology , CD4-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/immunology , Child , Child, Preschool , Disease Susceptibility/blood , Disease Susceptibility/immunology , Early Diagnosis , Female , Follow-Up Studies , Granulomatous Disease, Chronic/blood , Granulomatous Disease, Chronic/immunology , Humans , Infant , Male , Primary Immunodeficiency Diseases/blood , Primary Immunodeficiency Diseases/complications , Primary Immunodeficiency Diseases/immunology , Severe Combined Immunodeficiency , TuberculosisABSTRACT
Brucellosis is a significant health problem in countries where control of zoonoses is inadequate. During 1993-98, we analysed sera and cultures from 792 suspected brucellosis patients who presented with histories of fever, chills, night sweating, weakness, malaise and headache to the referral hospital in Yazd. Cases were investigated by tube agglutination test (TAT) and 2-mercaptoethanol test (2-MET) and a questionnaire was completed for each.TAT titre was > or = 1:1 60 for 745 patients (94.1%) and 2-MET was positive for 42 (5.3%). Of 745 confirmed cases, 460 were from 1996-1997. Prevalence was highest in summer (39.5%) and more common males than among females. Prevalence was highest among those aged 10-19 years (27.7%). Most patients had a history of infected cheese, milk and milk product consumption (98%).
Subject(s)
Brucellosis/epidemiology , Urban Health/statistics & numerical data , Adolescent , Adult , Agglutination Tests , Antibodies, Bacterial/blood , Brucella/immunology , Brucellosis/blood , Brucellosis/immunology , Brucellosis/transmission , Chi-Square Distribution , Child , Dairy Products/microbiology , Female , Food Microbiology , Humans , Immunoglobulin G/blood , Iran/epidemiology , Male , Mercaptoethanol , Middle Aged , Population Surveillance , Risk Factors , Seasons , Seroepidemiologic Studies , Sex Distribution , Surveys and QuestionnairesABSTRACT
Brucellosis is a significant health problem in countries where control of zoonoses is inadequate. During 1993-98, we analysed sera and cultures from 792 suspected brucellosis patients who presented with histories of fever, chills, night sweating, weakness, malaise and headache to the referral hospital in Yazd. Cases were investigated by tube agglutination test [TAT] and 2-mercaptoethanol test [2-MET] and a questionnaire was completed for each.TAT titre was > / = 1:1 60 for 745 patients [94.1%] and 2-MET was positive for 42 [5.3%]. Of 745 confirmed cases, 460 were from 1996-1997. Prevalence was highest in summer [39.5%] and more common males than among females. Prevalence was highest among those aged 10-19 years [27.7%]. Most patients had a history of infected cheese, milk and milk product consumption [98%]
