[PAGID] possible SCID

[John Ziegler]

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Remember that some Omenns can be very sensitive to chemotherapy. 

-----Original Message-----
From: pagid-bounces at list.clinimmsoc.org
[mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Abraham, Roshini S.,
Ph.D.
Sent: Tuesday, 24 February 2009 2:48 AM
To: pagid at list.clinimmsoc.org
Cc: Aly.Mageed at devoschildrens.org
Subject: Re: [PAGID] possible SCID





Thank you for all the suggestions and comments we have received: here is an
update:


We have been trying to taper off steroids to repeat Mitogen Stim off
steroids. The patient developed rash again and we sent of the testing with
CGH, TREC, CD4 recent thymic emigrants (to look for recent thymic
activity) working on where to send spectratyping (?suggestions).
Meanwhile, IGE level is 1430 off steroids (was only 9 on steroids!!) ,
making it likely to be Omenn despite no enlarged nodes, or enlarged L-S.
Eos is up in the 20+%( AEC around 800). Also, a recent BAL  ( was tachypneic
and with some chest infiltrate) is +  for Rhino virus. Any further
suggestions as far as BMT conditioning (MSD) and Rhino MGT ( which can be a
problem during BMT)?

Thanks,

 
Aly Mageed, MD, MBA
Division Chief, Pediatric Blood & Marrow Transplant Program Director, Stem
Cell Engineering Laboratory Helen DeVos Children's Hospital, Spectrum Health
Associate Professor of Pediatrics, Michigan State University Grand Rapids,
MI
(616)-391-3962
aly.mageed at spectrum-health.org


Roshini S. Abraham, Ph.D., D(ABMLI)
Mayo Clinic
Rochester, MN