[PAGID] IVIG or not?

[Richard Wasserman]

I would treat. So far prophylaxis has been lucky but his next pneumonia
could result in bronchiectasis.
Richard Wasserman

On Wed, Apr 28, 2010 at 1:37 PM, Kobrynski, Lisa <lkobryn at emory.edu> wrote:


>   I wanted to get some opinions on whether most people would start IVIG or

> not on this child.

> An 11 yr old boy with asthma who had several pneumonias (CXR positive)

> since 2006.  He has GERD, no aspiration, chest CT unremarkeable.  He was on

> antibiotic prophylaxis with azithromycin (MWF) and has been well for 2

> winters.  Initial IgG was a little low 455, but has dropped witheach

> measurement to 287.  Specific antibody titers are protective to protein and

> polysaccharide antigens.  Flow is normal, B cell panel normal.  No other

> infections.

>

> I waited to see what his IgG would do since he was well, but at this point

> he is not turning around.

> So, who would go ahead and start IVIG now?  Any additional tests to

> consider?

>

> Thanks

> Lisa

>

> Lisa Kobrynski, MD, MPH

> Associate Professor of Pediatrics

> Section, Allergy/Immunology

>

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-- 
Richard L. Wasserman, MD, PhD
DallasAllergyImmunology
7777 Forest Lane, Suite B-332
Dallas, Texas 75230
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