[PAGID] patient who lacks long-term memory antibody responses

[Prof. Dr. Antonio Condino Neto]

My two patients are the same. No GI problems
-- 
Antonio Condino-Neto, MD, PhD
Associate Professor - Department of Immunology
Institute of Biomedical Sciences - University of São Paulo
1730 Lineu Prestes Avenue, São Paulo - SP. ZIP 05508-000. Brazil
Tel (55) (11) 3091-7387 / Fax (55) (11) 3091-7224



Citando Howard M Lederman <hlederm1 at jhmi.edu>:


> Thanks to all who have responded so far.

>

> My pt has no h/o diarrhea, nl serum albumin, and nl stool alpha-1  

> anti-trypsin  - so I doubt a GI explanation.

>

> Howard

> Howard M. Lederman, M.D., Ph.D.

> Professor of Pediatrics, Medicine and Pathology

> Division of Pediatric Allergy and Immunology

> Johns Hopkins Hospital - CMSC 1102

> 600 N. Wolfe Street

> Baltimore, MD 21287-3923

> Phone: 410-955-5883

> Fax: 410-955-0229

> Email: Hlederm1 at jhem.jhmi.edu

>

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>

> ----- Original Message -----

> From: "Kirkpatrick, Charles" <Charles.Kirkpatrick at ucdenver.edu>

> Date: Friday, July 17, 2009 3:46 pm

> Subject: Re: [PAGID] patient who lacks long-term memory antibody responses

> To: "'pagid at list.clinimmsoc.org'" <pagid at list.clinimmsoc.org>

>

>

>> Howard;  I have some thing similar inpatients with intestinal protein

>> leaks (intestinal lymphangiectasia and celiac disease).  The patient

>> with celiac disease had an antibody half-life of 9 days.  If you

>> decide to try IgG replacement, I suggest giving subcutaneously.  This

>> depot mode seems to have better efficacy.

>>

>>  Chuck Kirkpatrick

>>

>>  -----Original Message-----

>>  From: pagid-bounces at list.clinimmsoc.org [ On Behalf Of Howard M Lederman

>>  Sent: Thursday, July 16, 2009 12:50 PM

>>  To: PAGID LISTSERV

>>  Subject: [PAGID] patient who lacks long-term memory antibody responses

>>

>>

>>  I have a fascinating  12 yr old male patient with a history of

>> recurrent infections (mostly upper and lower respiratory tract).  No

>> individual infection has been overwhelmingly severe, but the sum of

>> all infections leads to a significant number of school absences.

>>

>>  He has low IgG and IgM levels with normal IgA levels.  He makes

>> normal IgG antibody responses to a wide variety of vaccines, but does

>> not seem to be able to maintain long-term immunity.  (See attached

>> spreadsheet.  Sheet 1 tabulates the antibody and immunglobulin levels;

>> sheet 2 lists the immunizations.)

>>

>>  Is this a pattern that others have seen?    I am open to any ideas

>> for further evaluation.  Would anyone offer this child gamma globulin?

>>

>>  Howard

>>  Howard M. Lederman, M.D., Ph.D.

>>  Professor of Pediatrics, Medicine and Pathology

>>  Division of Pediatric Allergy and Immunology

>>  Johns Hopkins Hospital - CMSC 1102

>>  600 N. Wolfe Street

>>  Baltimore, MD 21287-3923

>>  Phone: 410-955-5883

>>  Fax: 410-955-0229

>>  Email: Hlederm1 at jhem.jhmi.edu

>>

>>  WARNING: E-mail sent over the Internet is not secure.

>>  Information sent by e-mail may not remain confidential.

>>

>>  DISCLAIMER: This e-mail is intended only for the

>>  individual to whom it is addressed. It may be used only in accordance

>> with applicable laws. If you received this e-mail by mistake, please

>> notify the sender and destroy the e-mail.

>>

>>

>




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