[PAGID] Hyper IgE therapy?

[Saxon, Andy M.D.]

Thanks Richard.  

He may have fungal infection so they do have that covered. They will try to reduce his steroids - apparently he has been on enough - long enough that he is likely dependent plus they are giving higher doses right now because of DIC etc.  I did have them give him IVIg dose after at least sending Ig levels since we don't know what his Ig levels have been.  

Andy Saxon, UCLA

 

-----Original Message-----
From: pagid-bounces at list.clinimmsoc.org
[mailto:pagid-bounces at list.clinimmsoc.org]On Behalf Of Richard L.
Wasserman, M.D.,Ph.D.
Sent: Thursday, September 13, 2007 7:42 PM
To: pagid at list.clinimmsoc.org
Subject: Re: [PAGID] Hyper IgE therapy?


My personal experience is that fungal infection has been a common 
terminal event. Steroid use in these patients has been associated with 
fungal infection. I would add impiric anti-fungal therapy and work hard 
to minimize steroids. If there is an identified bacterial pathogen 
passive immunization with IVIG may be helpful.
Richard Wasserman

Saxon, Andy M.D. wrote:


>We have just received an very ill 28 yo man with alleged Hyper IgE ID who is septic, dic etc. My question is:

>

>"Is there any immune directive intervention that is useful in this disease in general?"  

>

>He is receiving excellent agressive regular medical management and unfortunately is on a necessary dose of steroids. I'm not aware of any proven cytokine, hematopoetic factor etc that has been shown to improve the underlying immune problem.

>

>You rapid input even to say nothing new is out there would be greatly appreciated.

>

>Andy Saxon, MD

>UCLA 

>

>

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