PEDIATRICS Vol. 34 No. 1 July 1964, pp. 140
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Letters to the Editor

FRED S. ROSEN M.D.1

1 Department of Pediatrics, Harvard Medical School, Children's Hospital, 300 Longwood Avenue, Boston, Massachusetts

Our contention that the lymphopenic variety of agammaglobulinemia results in progressive vaccinia has been confirmed by Flewett and Ker (J. Clin. Path., 16:271). These workers described a 4-month-old child who developed progressive vaccinia which was fatal despite treatment with hyperimmune antiserum and a beta-thiosemicarbazone derivative. This infant had 600 lymphocytes per cu. mm. No thymus gland was found in this child at autopsy except for a few fibrous strands in which no Hassall's corpuscles were present. The authors state that the case represented an example of "lympho-plasmocytic dysgenesis." Allibone, Goldie, and Marmion also report a case (Arch. Dis. Child., 39:26) of thymic aplasia and death from progressive vaccinia. This 3-month-old infant, who had 680 lymphocytes per cu. mm., was given transfusions of splenic and marrow cells from normal and fetal donors to no avail. The untoward response of lymphopenic infants to BCG, as pointed out by Davis, Wedgwood, and Matsaniotis, probably resides in the same basic defect.