Necrotizing Ulcer After BCG Vaccination in a Girl With Leukocyte-adhesion Deficiency Type 1

J Pediatr Hematol Oncol. 2018 Jan;40(1):63-66. doi: 10.1097/MPH.0000000000000853.

Abstract

Leukocyte-adhesion deficiency-1 is a recessively inherited disorder associated with recurrent bacterial infections, severe periodontitis, peripheral leukocytosis, and impaired wound healing. We diagnosed moderate-type leukocyte-adhesion deficiency-1 in a 7-year-old girl who developed a necrotizing ulcer after Bacillus Calmette-Guerin vaccination. The patient showed moderate expression of CD18 in neutrophils with a homozygous splice mutation with c.41_c.58+2dup20 of ITGB2 and experienced recurrent severe infections complicated with systemic lupus erythematosus. She received hematopoietic stem cell transplantation from a matched elder brother with heterozygous mutation of ITGB2, and has since remained free of infection and systemic lupus erythematosus symptoms without immunosuppression therapy.

Publication types

  • Case Reports

MeSH terms

  • CD18 Antigens / analysis
  • CD18 Antigens / genetics*
  • Child
  • Female
  • Hematopoietic Stem Cell Transplantation / methods*
  • Heterozygote
  • Homozygote
  • Humans
  • Leukocyte-Adhesion Deficiency Syndrome / complications*
  • Leukocyte-Adhesion Deficiency Syndrome / diagnosis
  • Leukocyte-Adhesion Deficiency Syndrome / therapy
  • Male
  • Mutation
  • Mycobacterium bovis / immunology*
  • Necrosis
  • Neutrophils / cytology
  • Siblings
  • Treatment Outcome
  • Ulcer / etiology*
  • Ulcer / therapy
  • Vaccination / adverse effects*

Substances

  • CD18 Antigens

Supplementary concepts

  • Leukocyte adhesion deficiency type 1