title: [Disseminated Tuberculosis in an Infant with IFNg-IL-12/IL 23 Axis Defect].
abstract: BCG vaccine contains low virulence Mycobacterium bovis bacillus. In Mexico it is given at birth with few reported adverse reactions in immunocompetent children; however, in immuno-compromised patients it can cause serious local or systemic adverse reactions. The most frequent related diseases include chronic granulomatous disease (CGD), human immunodeficiency virus infection (HIV), severe combined immunodeficiency (SCID) and mendelian susceptibility to mycobacterial disease (MSMD). At this time, the innate defect of the IFN-?/IL-12/IL-23 axis constitutes the main implied alteration in patients with MSMD. We present the case of an infant with disseminated mycobacterial infection and history of BCG given at birth and documentation of an altered functional study of the IFN-?/IL12/IL-23 axis, specifically at the IL-12 pathway, which is susceptible to improve with exogenous IFN-? administration. Treatment was started with antituberculous drugs plus subcutaneous IFN-?, with a marked clinical improvement. In children with disseminated infection by weakly virulent intracellular microorganisms, such as the species included in BCG vaccine, primary or secondary underlying immunodeficiency should be ruled out.
authors.affiliation: Departamento de Alergia e InmunologÌa ClÌnica Pedi·trica, Hospital Infantil de MÈxico Federico GÛmez, MÈxico, D.F.
authors.forename: Eunice
authors.initials: E
authors.lastname: Sandoval-Ramìrez
authors.forename: Dino Roberto
authors.initials: DR
authors.lastname: Pietropaolo-Cienfuegos
authors.forename: Antonio
authors.initials: A
authors.lastname: Zamora-Chávez
authors.forename: Noé
authors.initials: N
authors.lastname: Ramírez-Alejo
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Santos-Argumedo
authors.forename: Lizbeth
authors.initials: L
authors.lastname: Blancas-Galicia
authors.forename: Blanca Estela
authors.initials: BE
authors.lastname: Del-Río-Navarro
mesh_terms: D001500:BCG Vaccine; D006801:Humans; D007223:Infant; D007371:Interferon-gamma; D018664:Interleukin-12; D053759:Interleukin-23; D009163:Mycobacterium bovis
chemical_list: D001500:BCG Vaccine; D053759:Interleukin-23; D018664:Interleukin-12; D007371:Interferon-gamma