Respiratory syncytial virus infection in an infant with familial Noonan disease and hypertrophic obstructive cardiomyopathy

Issues Associated With Respiratory Syncytial Virus Immunoprophylaxis and Immunization

“…In a recent article about the case of RSV in an acutely critical infant with familial Noonan syndrome and hypertrophic obstructive cardiomyopathy who did not receive seasonal palivizumab immunoprophylaxis, we discussed the international and local recommendations for palivizumab prophylaxis for children with heart disease. 6 Predictors of severe RSV infection in patients with heart disease were heart failure, pulmonary hypertension, and severe airway abnormalities associated with congenital heart disease. 7 International guidelines about palivizumab immune prophylaxis are generally targeted for specific groups of infants, namely, infants younger than 1 year with hemodynamically significant congenital heart disease; infants younger than 1 year with neuromuscular disorders impairing the ability to clear secretions from the upper airways, or with pulmonary abnormalities; children younger than 2 years of age with severe combined immunodeficiency, or who have undergone lung transplantation or hematopoietic stem cell transplantation during the RSV season; and children with Down syndrome who have additional risk factors for lower respiratory tract infections such as congenital heart disease, chronic lung disease, or premature birth.…”

“…International guidance for use of palivizumab in infants with inborn metabolic disease (eg, hyperammonemic vs nonhyperammonemic disorders), 10 genetic disorders (eg, Noonan, PTEN mutation, etc), 6,11 or neurodevelopmental disorders (eg, autistic spectrum disorder, myasthenia gravis, etc) 1,12 is less well defined. Decisions regarding palivizumab prophylaxis for children in these groups should be made on clinical grounds and by a case-by-case basis.…”

“…In a recent article about the case of RSV in an acutely critical infant with familial Noonan syndrome and hypertrophic obstructive cardiomyopathy who did not receive seasonal palivizumab immunoprophylaxis, we discussed the international and local recommendations for palivizumab prophylaxis for children with heart disease 6 . Predictors of severe RSV infection in patients with heart disease were heart failure, pulmonary hypertension, and severe airway abnormalities associated with congenital heart disease 7 .…”