title: Disseminated varicella infection caused by varicella vaccine strain in a child with low invariant natural killer T cells and diminished CD1d expression.
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.
  
  
  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.
authors: Laboratory for Bone Marrow Transplantation, The Queensland Institute of Medical Research, Herston, Australia. tatjana.banovic@qimr.edu.au
authors: Tatjana
authors: T
authors: Banovic
authors: Mayonelo
authors: M
authors: Yanilla
authors: Russell
authors: R
authors: Simmons
authors: Ian
authors: I
authors: Robertson
authors: Wayne A
authors: WA
authors: Schroder
authors: Neil C
authors: NC
authors: Raffelt
authors: Yana A
authors: YA
authors: Wilson
authors: Geoffrey R
authors: GR
authors: Hill
authors: Patrick
authors: P
authors: Hogan
authors: Clare B
authors: CB
authors: Nourse
mesh_terms: D055610:Antigens, CD1d / Q000378:metabolism*; D049109:Cell Proliferation; D002644:Chickenpox / Q000188:drug therapy / Q000276:immunology* / Q000821:virology; D019433:Chickenpox Vaccine / Q000009:adverse effects*; D002648:Child; D014645:Herpesvirus 3, Human / Q000276:immunology*; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism; D018655:Lymphocyte Count; D008297:Male; D055611:Natural Killer T-Cells / Q000276:immunology* / Q000378:metabolism; D014611:Vaccination / Q000009:adverse effects*; D014613:Vaccines, Attenuated / Q000009:adverse effects
chemical_list: D055610:Antigens, CD1d; C526877:CD1D protein, human; D019433:Chickenpox Vaccine; D014613:Vaccines, Attenuated; D007371:Interferon-gamma