Else M. Bijker (United Kingdom)

University of Oxford Paediatrics
I am a paediatrician from the Netherlands with special interest in tropical and infectious diseases. I currently work as a postdoctoral researcher at the Oxford Vaccine Group, University of Oxford, on a 5-year NIH-funded project to investigate novel diagnostics for paediatric TB. I studied medicine at Maastricht University, the Netherlands and completed my PhD (thesis: “Constructing protection and immune responses against malaria. Studies on whole sporozoite immunization approaches”) cum laude in 2015 at the department of Medical Microbiology of the Radboud University Medical Center in Nijmegen, the Netherlands. I was trained in paediatrics at the Canisius Wilhelmina Hospital, the Radboud University Medical Center and the Amsterdam University Medical Center in the Netherlands and the Queen Elizabeth Central Hospital in Blantyre, Malawi, and I was trained in paediatric infectious diseases and immunology at the John Radcliffe Hospital in Oxford, UK.

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SCREENING FOR IMMUNODEFICIENCIES IN CHILDREN WITH INVASIVE PNEUMOCOCCAL INFECTION: SIX-YEAR EXPERIENCE FROM A UK CHILDREN’S HOSPITAL (ID 580)

Session Name
2205 - ORAL PRESENTATIONS 04: EPIDEMIOLOGY (ID 34)
Lecture Time
10:51 - 10:58
Room
Hall 01
Presenter

Abstract

Background

Previous studies showed that comprehensive investigation of children with invasive pneumococcal disease (IPD), revealed an immunodeficiency in up to 10% of cases. Following this report, we implemented a protocol to investigate children presenting with IPD, to assess the proportion with an immunodeficiency in our setting.

Methods

We retrospectively identified patients with IPD by searching the microbiological and immunological databases of the Oxford Children’s Hospital, UK, from January 2015 – November 2020, and collected clinical and laboratory data from the medical records. The following immunological investigations were performed: complement C3 and C4 levels, classical and alternative pathway complement function, IgG, IgA and IgM levels, specific IgG levels (H. influenza B, tetanus, and pneumococcal serotypes), lymphocyte subsets, and CD62L in selected cases. Analysis of vaccine responses is ongoing.

Results

Immunological investigations were performed in 51 children with IPD. Four children (7.8%) had abnormal findings that were deemed of clinical significance; two children were diagnosed with complement deficiencies (Factor I and C2 deficiency), one child had persistently low anti-pneumococcal antibodies, and another child had low IgM, low NK-cells and poor persistence of pneumococcal antibodies. In an additional thirteen children with IPD, no immunological investigations were performed. Of these children, four died and four had possible explanations for the infection (sickle cell disease, tocilizumab treatment, leukaemia treatment and skull base fracture).

Conclusions

We identified clinically relevant abnormal immunological findings in 7.8% of children with IPD. This result might be an underestimation, since children who died were not tested. Our results support the recommendation to perform immunological investigations in children with IPD, since this might reveal underlying immunodeficiencies at an early stage, allowing for necessary preventive measures and close follow-up.

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