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November 1, 2018

Other Illnesses

Question from Canton, Michigan, USA:

Diagnosed with type 1 at age seven, my 16-year-old son has had celiac since he was eight, was anaphylactic to peanuts at 18 months and allergic to three antibiotics. Because they know celiac kids don't get immunity very well for Hep B from the shots in their first year, we had him tested and, sure enough, no immunity for Heb B. So, we got him a series last year and upon testing, yes, he did develop immunity. His pediatrician had him tested for mumps titers (because a local university has a small outbreak of mumps (four students). His mumps titers were "equivocal" which means he does not carry immunity even though I am up to date with ALL his shots, and on the recommended schedule. Why might he not be getting immunity from these shot? I am going to ask to see an immunologist for him, but have you heard of this before?

Answer:

This is a very difficult question. I think getting an immunologist evaluation is a good idea but I suspect it is not at all related to his having type 1 diabetes or another autoimmune problem like celiac disease. Your medical team should also have probably checked for other autoimmune problems that go together, i.e., Hashimoto’s thyroiditis and gastroparietal antibodies (pernicious anemia with folic acid and B2 deficiencies) as well as adrenal insufficiency (adrenalitis with cortisone deficiencies) since those are the others that may be involved. We know that there are specific HLA genes involved with such problems but the low immunity to infectious diseases is usually not similarly related.

SB