ABSTRACT
OBJECTIVES: (1) To determine serotype-specific IgG antibody responses to reimmunization with pneumococcal polysaccharide vaccine at age 5 years in children with sickle cell anemia and (2) to determine whether continued penicillin prophylaxis had any adverse effects on these responses. STUDY DESIGN: Children with sickle cell anemia, who had been treated with prophylactic penicillin for at least 2 years before their fifth birthday, were randomly selected at age 5 years to continue penicillin prophylaxis or to receive placebo treatment. These children had been immunized once or twice in early childhood with pneumococcal polysaccharide vaccine and were reimmunized at the time of randomization. RESULTS: Serotype-specific IgG antibody responses to reimmunization varied according to pneumococcal serotype but in general were mediocre or poor; the poorest response was to serotype 6B. The antibody responses were similar in subjects with continued penicillin prophylaxis or placebo treatment, and in subjects who received one or two pneumococcal vaccinations before reimmunization. The occurrence of pneumococcal bacteremia was associated with low IgG antibody concentrations to the infecting serotype. CONCLUSIONS: Reimmunization of children with sickle cell anemia who received pneumococcal polysaccharide vaccine at age 5 years induces limited production of serotype-specific IgG antibodies, regardless of previous pneumococcal vaccine history. Continued penicillin prophylaxis does not interfere with serotype-specific IgG antibody responses to reimmunization.
Subject(s)
Anemia, Sickle Cell/immunology , Antibodies, Bacterial/blood , Antibody Specificity , Bacterial Vaccines/immunology , Immunoglobulin G/blood , Penicillins/therapeutic use , Pneumococcal Infections/prevention & control , Polysaccharides, Bacterial/immunology , Streptococcus pneumoniae/immunology , Adult , Anemia, Sickle Cell/complications , Bacterial Vaccines/administration & dosage , Child, Preschool , Female , Humans , Immunization, Secondary , Male , Penicillins/adverse effects , Pneumococcal Infections/etiology , Pneumococcal Infections/immunology , Serotyping , Streptococcus pneumoniae/classification , beta-Thalassemia/complications , beta-Thalassemia/immunologySubject(s)
Facial Injuries , Leukemia, Lymphoid , Soft Tissue Neoplasms , Acute Disease , Adult , Antineoplastic Agents/therapeutic use , Female , Humans , Leukemia, Lymphoid/drug therapy , Leukemia, Lymphoid/pathology , Recurrence , Remission, Spontaneous , Soft Tissue Neoplasms/drug therapy , Soft Tissue Neoplasms/pathologyABSTRACT
In 40 premature infants, in whom severe respiratory distress precluded oral feeding, peripheral total parenteral nutrition consisting of casein hydrosylate, dextrose, and soybean emulsion was compared to nutrition with dextrose and electrolytes. The TPN group received more calories, and the total serum protein in them increased significantly. Metabolic complications did not occur. Transient thrombocytosis occurred in six infants who received TPN and eosinophilia occurred in nine. The case fatality rate in the TPN group (three of 20) was not significantly less than in the glucose group (six of 20). The differences suggested that infants who weigh less than 1,500 gm may receive the greater benefit from TPN.