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Vaccine Associated Paralytic Poliomyelitis Unmasking Common Variable Immunodeficiency
Sunil Gomber1, Vanny Arora, Pooja Dewan
1Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi 110095, India. Correspondence to: Dr Sunil Gomber, Director-Professor, Department of Pediatrics, Guru Teg Bahadur Hospital, Dilshad Garden. Delhi 110 095, India. sunilgomber@hotmail.com.
Indian Pediatrics
|April 1, 2017
Summary
Oral polio vaccine can cause Vaccine-associated paralytic poliomyelitis (VAPP). This case highlights the importance of screening children with VAPP for underlying immunodeficiency.
Area of Science:
- Pediatrics
- Immunology
- Infectious Diseases
Background:
- Oral polio vaccine (OPV) is a critical tool for polio eradication but carries a rare risk of Vaccine-associated paralytic poliomyelitis (VAPP).
- VAPP can present with neurological symptoms mimicking other conditions.
Observation:
- A 2-year-old child developed asymmetric lower limb paralysis after receiving an oral polio vaccine booster.
- Type 2 Vaccine-derived poliovirus (VDPV) was isolated from the patient.
- The child was subsequently diagnosed with common variable immunodeficiency, a primary immunodeficiency disorder.
Findings:
- The patient's paralysis showed gradual improvement over time.
- Treatment with monthly intravenous immunoglobulin was initiated for the underlying immunodeficiency.
Implications:
- This case underscores the necessity of investigating children diagnosed with VAPP for potential underlying immunodeficiencies.
- Early identification of immunodeficiency can guide appropriate management and improve patient outcomes.
- Consideration of immunodeficiency in VAPP cases may refine vaccination strategies and patient care protocols.