Disseminated varicella infection caused by varicella vaccine strain in a child with low invariant natural killer T cells and diminished CD1d lxpression

Tatjana Banovic, Mayonelo Yanilla, Russel Simmons, Ian Robertson, Wayne Schroder, Neil Raffelt, Yana Wilson, Geoffrey Hill, Patrick Hogan, Clare Nourse

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    43 Citations (Scopus)

    Abstract

    Background. Live attenuated varicella vaccine is considered a safe vaccine with serious adverse effects reported only in immunocompromised children. We describe a severe life-threatening infection with varicella vaccine virus causing rash and pneumonitis in a 6-year-old boy with no apparent immunodeficiency.Methods and Results. Polymerase chain reaction (PCR) analysis of vesicle swab samples demonstrated varicella zoster virus (VZV). Sequencing of the PCR product demonstrated 100% homology with human herpesvirus 3 strain VZV-Oka ORF62 gene. Routine immunologic investigations failed to demonstrate any abnormality. Total leukocyte, lymphocyte, and neutrophil counts and lymphocyte subsets were normal. Immunoglobulins, C3, C4, and CH50 were intact. Specific IgG to protein and polysaccharide antigens and to Epstein-Barr virus and cytomegalovirus were present. Normal lymphocyte proliferation to phytohemagglutinin and VZV antigens was detected. Neutrophil function and natural killer (NK) cell activity were normal. The analysis of invariant NK T (iNKT) cell numbers and function revealed diminished iNKT cells, reported once previously and unique to our patient, deficient expression of the cognate receptor, CD1d. Conclusions. This report provides a further link between deficiency of the iNKT/CD1d pathway and increased susceptibility to varicella vaccine virus, suggesting an important role of this innate pathway in host defense against yet another member of the herpesvirus family.

    Original languageEnglish
    Pages (from-to)1893-1901
    Number of pages9
    JournalJournal of Infectious Diseases
    Volume204
    Issue number12
    DOIs
    Publication statusPublished - 2011

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  • Cite this

    Banovic, T., Yanilla, M., Simmons, R., Robertson, I., Schroder, W., Raffelt, N., Wilson, Y., Hill, G., Hogan, P., & Nourse, C. (2011). Disseminated varicella infection caused by varicella vaccine strain in a child with low invariant natural killer T cells and diminished CD1d lxpression. Journal of Infectious Diseases, 204(12), 1893-1901. https://doi.org/10.1093/infdis/jir660