[PAGID] LAD and CMV

[Salem Tamemi]

CMV disease in the severe form of LAD-1 could be fatal (does your
patient have clinical disease, hepatosplenomegaly, pnemonitis) these
clinical entities could indolent and slowly progressive. You may want to
try Ganciclovir +/- CMV-IG or IVIG. The course of ganciclovir is 3 weeks
induction and then maintenance, if you are concerned about Bone marrow
suppression you may want to try Foscarnet although I don't think it is
liscenced in children yet but I have used it in a refractory CMV colitis
in an older child with hypogammaglobulinemia who didn't respond to
ganciclovir, and had very good response to Foscarnet.


Salem Al-Tamemi, MD.FAAP.FRCPC
Clinical Immunology & Allergy
Child Health Department 
Sultan Qaboos University Hospital (SQUH)
PO box 96
PC 123 Al-Khod 
Muscat - Oman 
Tel +968 99311622
Fax +968 24141136
E-mail, tamemi at squ.edu.om

		 
  

-----Original Message-----
From: pagid-bounces at clinimmsoc.org [mailto:pagid-bounces at clinimmsoc.org]
On Behalf Of Lisa Kobrynski, MD, MPH
Sent: Sunday, June 11, 2006 8:13 AM
To: pagid at clinimmsoc.org
Subject: [PAGID] LAD and CMV


We have a 4 month old with LAD1 who is going for transplant, but is CMV
PCR
positive now (with some IgM and a little IgG).  
What is the experience with pre-transplant CMV in LAD patients?
Treatment?
Duration?

Thanks


Lisa Kobrynski, MD, MPH
Assistant Professor of Pediatrics
Division of Allergy and Immunology
Emory University
404-727-3575
404-727-5045 (fax)