Immune status and response to immunization with polysaccharide vaccines of a healthy, congenitally asplenic woman.

We describe the immune status of a congenitally asplenic, otherwise healthy and anatomically normal 30-year-old woman. As in surgically asplenic subjects, she had Howell-Jolly bodies in a blood smear, increased B lymphocyte and decreased T helper and suppressor lymphocyte percentages, and a slightly lower than average T helper/suppressor ratio. Because of the increased risk of infection with capsulate bacteria in asplenic patients, the subject was immunized with Pneumovax and meningococcal vaccine and her serum antibody responses were investigated. She was found to have subnormal IgG antibody titres which did not increase on immunization, although the subclass distribution of anti-pneumococcal antibody was normal with IgG2 predominating. IgM antibody titres were higher than in a pool of normal adult human sera, while IgA levels increased substantially as in normal subjects.