Journal
JOURNAL OF CLINICAL IMMUNOLOGY
Volume 32, Issue 1, Pages 82-88Publisher
SPRINGER/PLENUM PUBLISHERS
DOI: 10.1007/s10875-011-9609-4
Keywords
SCID; TREC; lymphopenia; newborn screening
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Funding
- Children's Hospital of Wisconsin
- Jeffrey Modell Foundation
- Wisconsin State Laboratory of Hygiene
- Centers for Disease Control and Prevention [5U01EH000365]
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Severe combined immunodeficiency is a life-threatening primary immune deficiency characterized by low numbers of naive T cells. Early diagnosis and treatment of this disease decreases mortality. In 2008, Wisconsin began newborn screening of infants for severe combined immunodeficiency and other forms of T-cell lymphopenia by the T-cell receptor excision circle assay. In total, 207,696 infants were screened. Seventy-two infants had an abnormal assay. T-cell numbers were normal in 38 infants, abnormal in 33 infants, and not performed in one infant, giving a positive predictive value for T-cell lymphopenia of any cause of 45.83% and a specificity of 99.98%. Five infants with severe combined immunodeficiency/severe T-cell lymphopenia requiring hematopoietic stem cell transplantation or other therapy were detected. In summary, the T-cell receptor excision circle assay is a sensitive and specific test to identify infants with severe combined immunodeficiency and severe T-cell lymphopenia that leads to life-saving therapies such as hematopoietic stem cell transplantation prior to the acquisition of severe infections.
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