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Case Report: Rubella Virus-Induced Cutaneous Granulomas in Two Pediatric Patients With DNA Double Strand Breakage Repair Disorders - Outcome After Hematopoietic Stem Cell Transplantation. 2022
Ulrich Baumann, and
Johannes H Schulte, and
Jonathan P Groß, and
Rita Beier, and
Marius Ludwig, and
Volker Wahn, and
Jörg Hofmann, and
Britta Maecker-Kolhoff, and
Martin Sauer, and
Petra Kaiser-Labusch, and
Negin Karimian, and
Ulrike Blume-Peytavi, and
Franziska Ghoreschi, and
Hagen Ott, and
Ludmila Perelygina, and
Christian Klemann, and
Oliver Blankenstein, and
Horst von Bernuth, and
Renate Krüger
Paediatric Pulmonology, Allergy and Neonatology, Hannover Medical School, Hannover, Germany.
We report two patients with DNA repair disorders (Artemis deficiency, Ataxia telangiectasia) with destructive skin granulomas, presumably triggered by live-attenuated rubella vaccinations. Both patients showed reduced naïve T cells. Rapid resolution of skin lesions was observed following hematopoietic stem cell transplantation. However, the patient with AT died due to complications of severe hepatic veno-occlusive disease 6 month after HSCT. Dried blood spots obtained after birth were available from this patient and showed absent T-cell receptor excision circles (TRECs). Therefore, newborn screening may help to prevent patients with moderate T-cell deficiency from receiving live-attenuated rubella vaccine potentially causing granulomas.
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