[PAGID] IVIG potential benefit?

[Charlotte Cunningham-Rundles]

these titers sound basically normal to me also, so I'd think not as well.

Charlotte Cunningham-Rundles MD PhD
Professor of Medicine, Pediatrics  and Immunobiology
Mount Sinai School of Medicine
1425 Madison Ave, New York 10029
phone 212 659 9268
fax  212 987 5593
Email:  charlotte.cunningham-rundles at mssm.edu


>I have a new 36yo female patient with lupus, 
>recurrent otitis, and s/p a single episode of 
>pneumonia.  The pneumonia occurred 18 months ago 
>after an episode of pleurisy, and 
>was complicated by an empyema requiring surgery, 
>chest tubes, and a prolonged hospital stay.  s/p 
>left tympanoplasty x 2 as child and adult.  No 
>sinus disease ever.  Immune studies reveal 
>normal IgG (950-1200), normal IgA (260-315), and 
>a low IgM (17 after Rituxan - 31 before 
>Rituxan).  First set of pneumococcal titers were 
>drawn 1 year after a Pneumovax, and revealed IgG 
>Ab levels >3.5 ug/mL in 9 of the 14 serotypes. 
>Repeat pneumococcal titers revealed <2-fold 
>increase in 8 serotypes, 2-fold increase in 3 
>serotypes, and >2fold increase in 1 serotype, 
>with no change in the remaining 2 serotypes. 
>Tetanus, diphtheria, and Hib titers all 
>protective.  The specific question for her 
>referral to me is whether or not she could 
>benefit from IVIG.  I think, probably not.  Any 
>thoughts?
>
>
>
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