[PAGID] CGD pregnancy

[Conley, Mary-Ellen]

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Mary Ellen




Mary Ellen Conley, MD 
Department of Immunology 
St. Jude Children's Research Hospital 
332 N. Lauderdale 
Memphis, TN 38105-2794 
FAX  901-495-3977 
TEL  901-495-2576 

 


________________________________

	From: pagid-bounces at list.clinimmsoc.org
[mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Kari Nadeau
	Sent: Tuesday, February 05, 2008 11:42 PM
	To: pagid at list.clinimmsoc.org
	Subject: Re: [PAGID] CGD pregnancy
	
	
	Dear Jordan,
	 
	I recently had a 20 yo patient with AR CGD deliver a FT healthy
girl and she remained on septra, itra, clinda and keflex (we needed
double coverage for her) throughout the pregnancy and did extremely
well. We weighed the risks and the benefits and thought it prudent, in
this woman's case, to continue her prophylaxis given her history of
severe infections. 
	 
	Please feel free to contact me for any questions.
	All the best,
	Kari
	
	
	On Feb 5, 2008 9:31 PM, Jordan Orange
<orange at mail.med.upenn.edu> wrote:
	

		Dear Colleagues, 

		I currently have a 27yo patient with autosomal recessive
CGD who would like become pregnant.

		Does anyone have experience with this situation?

		I have many concerns.  

		One small, but practical concern is that both TMP/SMX
and itraconazole are pregnancy category C.  If she were to become
pregnant, is there an acceptable alternative prophylactic regimen which
would be safer for the fetus?  Alternatively, should TMP/SMX and
itraconazole be continued?
		
		
		This patient and her family have an appropriate fear of
CGD, as her younger sister died of fungal pneumonia 3 years ago.

		Thank you for reading this message and for any advice
you might be able to offer.

		Best regards,

		Jordan

		
		Jordan Orange MD/PhD
		Assistant Professor of Pediatrics
		University of Pennsylvania School of Medicine
		Children's Hospital of Philadelphia, Division of
Immunology
		3615 Civic Center Blvd,  ARC-1016H
		Philadelphia, PA 19104
		(Voice) 267-426-5622
		(Fax) 267-426-5727
		www.orangelab.org <http://www.orangelab.org/> 








	-- 
	Kari Nadeau, MD, PhD
	Academic Faculty, Stanford Medical School
	Division of Pulmonary, Allergy and Critical Care
	Director, Allergy Clinics, Stanford Medical Center and Lucile
Packard Children's Hospital
	Fax: 650-498-5560
	Phone: 650-723-5227
	knadeau at stanford.edu
	
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