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Acquired immunodeficiency in an infant: possible transmission by means of blood products
Insights
An infant developed recurrent infections and acquired immunodeficiency after multiple blood transfusions for rhesus disease. The findings suggest transmission of an unknown infectious agent via transfusion, highlighting transfusion safety concerns.
Area of Science:
- Immunology
- Infectious Diseases
- Pediatrics
Background:
- Rhesus disease necessitates transfusions in newborns.
- Infants with underlying conditions may be susceptible to infections.
Observation:
- An infant receiving multiple transfusions for rhesus disease developed severe, recurrent infections starting at 6 months.
- Diagnoses included hepatitis, thrush, Candida dermatitis, otitis media, and disseminated Mycobacterium avium intracellulare.
- Immunological evaluation revealed elevated immunoglobulins, impaired mononuclear cell responses, and a reduced helper/suppressor T cell ratio.
Findings:
- A blood donor later died from opportunistic infections and acquired immunodeficiency syndrome (AIDS).
- The infant's clinical presentation and immunological profile strongly suggest transfusion-acquired immunodeficiency.
- The causative agent was not identified as cytomegalovirus, Epstein-Barr virus, or hepatitis B virus.
Implications:
- Blood transfusions can transmit infectious agents causing acquired immunodeficiency.
- This case underscores the need for rigorous screening of blood donors for novel pathogens.
- Further research is required to identify the transmissible agent responsible for this infant's condition.
Abstract:
An infant who received multiple transfusions during the first few days of life for rhesus disease became ill with recurrent infections when 6 months old. Hepatitis, thrush, Candida dermatitis, otitis media, and disseminated Mycobacterium avium intracellulare infection occurred by 14 months of age. Immunological studies showed raised immunoglobulin levels, decreased mononuclear-cell responses to allogeneic cells and mitogen, and a decreased helper/suppressor cell ratio. It was determined that one of the blood donors, who was well at the time of blood donation, had died 17 months after with multiple opportunistic infections and acquired immunodeficiency. The clinical and laboratory findings in our patient suggest that he acquired a transmissible infectious agent from a blood transfusion, resulting in acquired immunodeficiency, and that this agent was not cytomegalovirus, Epstein-Barr virus, or hepatitis B virus.