| Abstract | BACKGROUND: Splenectomy predisposes patients to invasive disease from pneumococci, meningococci, and Haemophilus influenzae; immunization is mandatory. However, data on the impact of the splenectomy on vaccine immunogenicity are scarce. METHODS: A total of 41 children with hereditary spherocytosis (aged 5.8-14.4 years) had complete (16) or near-total (25) splenectomy. All received one dose of monovalent meningococcal C conjugate vaccine (MCV-C) and, 2 months later, a tetravalent meningococcal polysaccharide vaccine (MPV-ACWY). Serum bactericidal activity and antibodies against serogroups A and C were determined before and after they received MCV-C, and 4 weeks after they received MPV-ACWY. RESULTS: Before vaccination, only four of the 16 children who had a complete splenectomy were protected against serogroup A, compared with 15 of the 25 who had near-total splenectomy (P < 0.050), with the latter responding to immunization with significantly higher serogroup A serum bactericidal activity: geometric mean (95 per cent confidence interval) 1625.5 (49.9 to 3201.1) versus 980.6 (2.00 to 6204.1) (P < 0.050). All patients achieved putative protective serum bactericidal activity titres (at least 8) against serogroup C. CONCLUSION: Near-total splenectomy provides a favourable immunological basis for natural and vaccine-induced protection against meningococcal serogroup A and C infections. Sequential meningococcal vaccination is immunogenic in patients splenectomized for hereditary spherocytosis. |
| Authors | G A Stoehr, J Luecken, S Zielen, S W Eber, R Borrow, M A Rose
(Affiliation: Department of Surgery, Georg August University, Goettingen, Germany.)
|
| Journal | The British journal of surgery
(Br J Surg)
Vol. 95
Issue 4
Pg. 466-71
(Apr 2008)
ISSN: 1365-2168 England |
| PMID | 18161897
(Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
|
| Copyright | 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. |
| Chemical References |
- Antibodies, Bacterial
- Immunoglobulin G
- Meningococcal Vaccines
- serogroup C meningococcal conjugate vaccine
|
| Topics |
- Adolescent
- Antibodies, Bacterial
(metabolism)
- Child
- Child, Preschool
- Female
- Humans
- Immunoglobulin G
(metabolism)
- Male
- Meningococcal Infections
(immunology, prevention & control)
- Meningococcal Vaccines
(immunology)
- Postoperative Complications
(immunology, prevention & control)
- Prospective Studies
- Spherocytosis, Hereditary
(immunology)
- Splenectomy
(methods)
|
