Disseminated BCG pneumonitis revealing severe combined immunodeficiencyxs in CHARGE syndrome

Pediatr Pulmonol. 2017 Feb;52(2):E4-E6. doi: 10.1002/ppul.23533. Epub 2016 Nov 22.

Abstract

CHARGE (coloboma, heart defect, atresia choanae, retarded growth and development, genital hypoplasia, and ear anomalies/deafness) syndrome is a rare genetic disorder caused by CHD7 mutation and is related to immunodeficiency. A 6-month-old girl with right lung agenesis, congenital heart defects, and ear anomalies developed repeated and serious respiratory infection for a short period. She was clinically diagnosed with typical CHARGE syndrome with severe combined immunodeficiency (T-, B+, NK-); however, CHD7 mutation was not detected. Disseminated BCG infection did not resolve despite administration of anti-tuberculosis drugs and intravenous immune globulins, and she subsequently died of acute respiratory distress syndrome. Pediatr Pulmonol. 2017;52:E4-E6. © 2016 Wiley Periodicals, Inc.

Keywords: CHARGE syndrome; bacillus Calmette-Guérin; disseminated BCG; severe combined immunodeficiency.

Publication types

  • Case Reports

MeSH terms

  • Abnormalities, Multiple / diagnostic imaging
  • Adjuvants, Immunologic / adverse effects*
  • BCG Vaccine / adverse effects*
  • CHARGE Syndrome / complications*
  • Fatal Outcome
  • Female
  • Heart Defects, Congenital / complications
  • Heart Defects, Congenital / diagnostic imaging
  • Humans
  • Infant
  • Lung / abnormalities
  • Lung / diagnostic imaging
  • Lung Diseases / complications
  • Lung Diseases / diagnostic imaging
  • Mutation
  • Mycobacterium bovis
  • Respiratory Distress Syndrome, Newborn / etiology*
  • Respiratory Distress Syndrome, Newborn / immunology
  • Severe Combined Immunodeficiency / complications
  • Severe Combined Immunodeficiency / immunology*
  • Tomography, X-Ray Computed
  • Tuberculosis, Pulmonary / diagnostic imaging
  • Tuberculosis, Pulmonary / etiology*
  • Tuberculosis, Pulmonary / immunology

Substances

  • Adjuvants, Immunologic
  • BCG Vaccine

Supplementary concepts

  • Lung agenesis