Revista Alergia México

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>Journals >Revista Alergia México >Year 2012, Issue 2

Sandoval-Ramírez E, Pietropaolo- Cienfuegos DR, Zamora-Chávez A, Ramírez-Alejo N, Santos-Argumedo L, Blancas-Galicia L, del-Río-Navarro BE
Disseminated Tuberculosis in an Infant with IFNg-IL-12/ IL 23 Axis Defect
Revista Alergia México 2012; 59 (2)

Language: Español
References: 23
Page: 86-92
PDF: 114.50 Kb.

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BCG vaccine contains low virulence Mycobacterium bovis bacillus. In Mexico it is given at birth with few reported adverse reactions in immunocompetent children; however, in immuno-compromised patients it can cause serious local or systemic adverse reactions. The most frequent related diseases include chronic granulomatous disease (CGD), human immunodeficiency virus infection (HIV), severe combined immunodeficiency (SCID) and mendelian susceptibility to mycobacterial disease (MSMD). At this time, the innate defect of the IFN-γ/IL-12/IL-23 axis constitutes the main implied alteration in patients with MSMD. We present the case of an infant with disseminated mycobacterial infection and history of BCG given at birth and documentation of an altered functional study of the IFN-γ/IL12/IL-23 axis, specifically at the IL-12 pathway, which is susceptible to improve with exogenous IFN-γ administration. Treatment was started with antituberculous drugs plus subcutaneous IFN-γ, with a marked clinical improvement. In children with disseminated infection by weakly virulent intracellular microorganisms, such as the species included in BCG vaccine, primary or secondary underlying immunodeficiency should be ruled out.

Key words: MSMD, immunodeficiency, BCG, tuberculosis, mycobacterium.

>Journals >Revista Alergia México >Year 2012, Issue 2
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