Invasive pneumococcal disease in children can reveal a primary immunodeficiency

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

doi:10.1093/cid/ciu274

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Invasive pneumococcal disease in children can reveal a primary immunodeficiency

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Invasive pneumococcal disease in children can reveal a primary immunodeficiency

Jean Gaschignard, Corinne Levy, Maya Chrabieh, Bertrand Boisson, Cécile Bost-Bru, Stéphane Dauger, François Dubos, Philippe Durand, Joël Gaudelus, Dominique Gendrel, …

Clinical infectious diseases, Vol.59(2), pp.244-251

15/07/2014

DOI: https://doi.org/10.1093/cid/ciu274

PMID: 24759830

Résumé

Adolescent

Child

Child, Preschool

Disease Susceptibility

Female

France

Humans

Immunologic Deficiency Syndromes - complications

Infant

Male

Pneumococcal Infections - epidemiology

Pneumococcal Infections - immunology

Prospective Studies

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.

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Titre: Invasive pneumococcal disease in children can reveal a primary immunodeficiency
Créateurs - sans rôle: Jean Gaschignard - Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale UMR1163 University Paris Descartes, Sorbonne Paris Cité, Imagine Institute, Paris, France Groupe de Pathologie Infectieuse Pédiatrique, France
Corinne Levy - Groupe de Pathologie Infectieuse Pédiatrique, France Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur, France Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, Créteil, France
Maya Chrabieh - Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale UMR1163 University Paris Descartes, Sorbonne Paris Cité, Imagine Institute, Paris, France
Bertrand Boisson - St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, New York
Cécile Bost-Bru - Pediatric Unit, Grenoble Hospital, Grenoble, France
Stéphane Dauger - Assistance Publique – Hôpitaux de Paris
François Dubos - Groupe de Pathologie Infectieuse Pédiatrique, France Pediatric Emergency and Infectious Diseases Unit, Centre Hospitalier Régional Universitaire, UDSL, Lille, France
Philippe Durand - Pediatric Intensive Care Unit, Kremlin Bicêtre Hospital, APHP, Kremlin Bicêtre, France
Joël Gaudelus - Groupe de Pathologie Infectieuse Pédiatrique, France Pediatric Unit, Jean Verdier Hospital, APHP, Bondy, France
Dominique Gendrel - Groupe de Pathologie Infectieuse Pédiatrique, France Pediatric Unit, Necker Hospital, APHP, Paris, France
Christèle Gras Le Guen - Groupe de Pathologie Infectieuse Pédiatrique, France Pediatric Unit, Nantes Hospital, Nantes, France
Emmanuel Grimprel - Hôpital Armand-Trousseau
Gaël Guyon - Pediatric Unit, Montpellier Hospital, Montpellier, France
Catherine Jeudy - Pediatric Onco-Hematology Unit, Angers Hospital, Angers, France
Eric Jeziorski - Pediatric Unit, Montpellier Hospital, Montpellier, France
Francis Leclerc - Pediatric Intensive Care Unit, CHRU, Lille University Hospital, UDSL, Lille, France
Pierre-Louis Léger - Pediatric and Neonatal Intensive Care Units, Armand Trousseau Hospital, Paris, France
Fabrice Lesage - Pediatric Intensive Care Unit, Necker Hospital
Mathie Lorrot - Pediatric Unit, Robert Debré Hospital, APHP, Paris, France
Isabelle Pellier - Pediatric Onco-Hematology Unit, Angers Hospital, Angers, France
Didier Pinquier - Groupe de Pathologie Infectieuse Pédiatrique, France Pediatric Intensive Care Unit, Rouen Hospital, Rouen, France
Loïc de Pontual - Groupe de Pathologie Infectieuse Pédiatrique, France Pediatric Unit, Jean Verdier Hospital, APHP, Bondy, France
Philippe Sachs - Pediatric Intensive Care Unit, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris Paris (APHP), France
Caroline Thomas - Pediatric Intensive Care and Onco-Hematology Units, Nantes Hospital, Nantes, France
Pierre Tissières - Pediatric Intensive Care Unit, Kremlin Bicêtre Hospital, APHP, Kremlin Bicêtre, France
Frédéric V Valla - Hôpital Femme Mère Enfant
Philippe Desprez - Pediatric Intensive Care Unit, Hôpital Hautepierre, Strasbourg, France
Véronique Frémeaux-Bacchi - Hôpital Européen Georges-Pompidou
Emmanuelle Varon - Hôpital Européen Georges-Pompidou
Xavier Bossuyt - Laboratory Medicine, University Hospitals Leven and Experimental Laboratory Immunology, Department Microbiology and Immunology, Catholic University Leuven, Belgium
Robert Cohen - Groupe de Pathologie Infectieuse Pédiatrique, France Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur, France Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, Créteil, France
Laurent Abel - Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale UMR1163 University Paris Descartes, Sorbonne Paris Cité, Imagine Institute, Paris, France St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, New York
Jean-Laurent Casanova - Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale UMR1163 University Paris Descartes, Sorbonne Paris Cité, Imagine Institute, Paris, France St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, New York Pediatric Hematology-Immunology Unit, Necker-Enfants Malades Hospital, Paris, France Howard Hughes Medical Institute, New York, New York
Anne Puel - Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale UMR1163 University Paris Descartes, Sorbonne Paris Cité, Imagine Institute, Paris, France
Capucine Picard - Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale UMR1163 University Paris Descartes, Sorbonne Paris Cité, Imagine Institute, Paris, France Pediatric Hematology-Immunology Unit, Necker-Enfants Malades Hospital, Paris, France Center for the Study of Primary Immunodeficiencies, APHP, Necker Hospital, Paris, France
Détails de publication: Clinical infectious diseases, Vol.59(2), pp.244-251
Note de subvention: 8UL1TR000043 / NCATS NIH HHS UL1 TR000043 / NCATS NIH HHS P01 AI061093 / NIAID NIH HHS
Identifiants: 99148126409311
Unité académique: Pathogenesis and Control of Chronic and Emerging Infections - PCCEI
Langue: English
Type de ressource: Journal article