[PAGID] CVID fatigue

[HOWARD M LEDERMAN]

Given her age, gender and the propensity for CVID to be associated with autoimmune disease, have you checked her thyroid function?  As a general rule, I think that you must also consider depression in this setting as a dx separate from CVID.

Howard M. Lederman, M.D., Ph.D.
Professor of Pediatrics and Medicine
Division of Pediatric Allergy and Immunology
Johns Hopkins Hospital - CMSC 1102
600 N. Wolfe Street
Baltimore, MD 21287-3923
Phone:  410-955-5883
Fax:    410-955-0229
e-mail: Hlederm1 at jhem.jhmi.edu


----- Original Message -----
From: "Riedl, Marc" <MRiedl at mednet.ucla.edu>
Date: Monday, March 20, 2006 5:06 pm
Subject: [PAGID] CVID fatigue

> I have a 58 yo previously healthy woman recently diagnosed with 
> CVID (IgG
> 400, low IgA, h/o respiratory infections) who has suffered from 
> profounddisabling persistent fatigue for the past year. Increasing 
> her IgG dose has
> had no effect, nor is the fatigue cyclical related to her 
> infusions.  We
> have looked for chronic infection or monoclonal gammopathy without any
> findings.  She was formerly a successful, high-powered attorney 
> and appears
> very motivated to return to work but has "no energy".  I have a 
> sizeablenumber of CVI patients in my practice and have seen 
> associated fatigue, but
> not to this degree or intensity.
> 
> Does anyone have experience with this?  Any suggestions are 
> appreciated.
> 
> Thanks,
> 
> Marc
> 
> Marc Riedl, M.D., M.S. 
> Assistant Professor of Medicine 
> Clinical Immunology and Allergy 
> UCLA - David Geffen School of Medicine 
> 10833 Le Conte Ave, 52-175 CHS 
> Los Angeles, CA  90095 
> Tel 310.206.4345  Fax 310.206.8107
> 
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