[PAGID] IVIG for ParvoB19?

[Berger, Melvin]

Have you done a marrow ?  Have you looked at ferritin, etc to R/O hematophagocytic/macrophage activation type syndrome ?  
 
I assume he is Coombs negative. Any evidence of something like ALPS ? Jack Bleesing found an unusual mutation in a patient of ours who had recurrent coombs-negative hemolytic anemia and a huge spleen causing abdominal pain, but never had lymphadenopathy
 
Melvin Berger, M.D., Ph.D.
Professor of Pediatrics and Pathology
Case Western Reserve University
phone 216 844 3237
 
Director, Jeffrey Modell Center for Primary Immune Deficiencies
Division of Allergy-Immunology
Rainbow, Babies and Children's Hospital
University Hospitals of Cleveland
RB&C Rm 504, MS 6008B
11100 Euclid Ave.
Cleveland, OH 44106

________________________________

From: pagid-bounces at list.clinimmsoc.org on behalf of raas0027 at umn.edu
Sent: Mon 3/9/2009 2:18 PM
To: pagid at list.clinimmsoc.org
Subject: [PAGID] IVIG for ParvoB19?



Dear Colleagues,

I have a 13 year old male with 6p+4q- translocation and a host of
associated clinical issues.


>From an immune stadpoint, he has T-cell lymphopenia with a baseline CD3 of

under 400/uL. Clinically he has done well from an infection standpoint for
many years. He has normal mitogens as well as normal quantitative and
qualitative antibody response. Lots of other studes performed but to be
brief, were normal.

After 30+ days of nightly fever and modest splenomegaly, a id/heme workup
revealed only a positive PCR for parvovirus b19 in the peripheral blood.

The question of IVIG as treatment for Parvovirus B19 in a lymphopenic
patient was raised. I have never used IVIG in a case like this. Literature
data is spartan.

Any expererience out there?

Thank you!

Regards,

Jason

--


Jason P. Raasch, MD

Midwest Immunology Clinic
City Center Professional Building
15700 37th St NE
Suite 110
Plymouth, MN 55446

Office: 763.577.0008
FAX: 763.577.0192
raas0027 at umn.edu




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