title: Disseminated bacille Calmette-Guérin in Iranian children with severe combined immunodeficiency.
abstract: BACKGROUND
  The bacille Calmette-Guérin (BCG) vaccine is a widely practiced vaccine, which is useful for prophylaxis against tuberculosis. Disseminated BCG infection (BCG-osis) is one of the most important complications of this vaccine and can be seen in patients with an underlying immunodeficiency. This study was performed to determine the underlying defects in patients with BCG-osis.
  
  
  METHODS
  Immunological evaluation was performed in all children who developed BCG-osis after vaccination in Tabriz, Iran.
  
  
  RESULTS
  BCG-osis was documented in eight patients following vaccination. Axillary adenitis was detected in seven patients, and hepatosplenomegaly was also found in seven patients. Immunological studies revealed low serum IgG, IgM and IgA levels in all patients. Further investigations for enumeration of the lymphocyte sub-population revealed severe combined immunodeficiency (SCID) in all the patients. Three patients had T-B+NK- SCID, four had T-B-NK+ SCID, and one had T-B+NK+ SCID. Unfortunately, all the patients died due to the severe disseminated BCG infection.
  
  
  CONCLUSIONS
  Inoculation of live vaccines such as BCG should be postponed for a few months in suspected cases of primary immunodeficiency disease, until appropriate screening tests exclude this diagnosis; vaccination should then be performed in those with an intact immune system.
authors.affiliation: Division of Pediatric Immunology and Allergy, Children's Hospital, Tabriz University (Medical Sciences), Tabriz, Iran. drsadeghim2004@yahoo.com
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Sadeghi-Shabestari
authors.forename: Nima
authors.initials: N
authors.lastname: Rezaei
mesh_terms: D001500:BCG Vaccine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D007492:Iran; D008297:Male; D009163:Mycobacterium bovis / Q000276:immunology / Q000472:pathogenicity; D016511:Severe Combined Immunodeficiency / Q000150:complications* / Q000175:diagnosis; D014376:Tuberculosis / Q000175:diagnosis* / Q000382:microbiology / Q000517:prevention & control*; D014611:Vaccination / Q000009:adverse effects
chemical_list: D001500:BCG Vaccine