[CIS-PAGID] psoriasis in patients on SQ gammaglobulin

[Jason Raasch, MD]

Interesting.  I have a gentleman with CVID and psoriasis which was in remission.  He has flared recently and been difficult to control without steroids.

Now that you mention it, his flare coincides with transitioning to Hizentra.

Some literature out there regarding increased expression of proline hydorxylase in psoriatic skin.  Also increased hydroxyproline urinary excretion associted with psoriasis skin flares.

Could the extra proline be fueling the fire?

Jason Raasch, MD
Midwest Immunology Clinic



On Apr 1, 2011, at 11:36 AM, Conley, Mary Ellen wrote:


> Dear Colleagues,

> We have had 3 patients with XLA who have developed psoriasis soon after they were switched to the new IVIG preparation, Hizentra.  Two of them may have had mild psoriasis while they were on SQ Vivaglobulin but the psoriasis became much worse on the Hizentra.  In my loooong history of seeing patients with XLA, I had not seen psoriasis before.  Is this a coincidence?  Anybody with similar experience?

> Mary Ellen

> 

> 

> 

> 

> Mary Ellen Conley, MD 

> Department of Immunology/ Mail Stop 351 

> St. Jude Children's Research Hospital 

> 262 Danny Thomas Place 

> Memphis, TN 38105-3678 

> FAX  901-595-3977 

> TEL  901-595-2576

> 

>  

> 

> From: pagid-bounces at list.clinimmsoc.org [mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Church, Joseph

> Sent: Friday, April 01, 2011 9:27 AM

> To: pagid at list.clinimmsoc.org

> Subject: Re: [CIS-PAGID] Pneumovax 23 in older adults

> 

> Excellent!  Thanks so much.  JC

>  

> From: pagid-bounces at list.clinimmsoc.org [mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Hare, Nathaniel D

> Sent: Friday, April 01, 2011 7:25 AM

> To: pagid at list.clinimmsoc.org

> Subject: Re: [CIS-PAGID] Pneumovax 23 in older adults

>  

> Joe,

>  

> These two papers may help as well.

>  

> Nathan Hare MD

> Allergy Immunology

> Cheshire Medical Center – Dartmouth Hitchcock Keene

> Keene, NH

>  

> Artz AS, Ershler WB, Longo DL. Pneumococcal vaccination and revaccination of

> older adults. Clin Microbiol Rev 2003;16:308-18.

>  

> Rubins JB, Puri AK, Loch J, Charboneau D, MacDonald R, Opstad N, et al. Magnitude,

> duration, quality, and function of pneumococcal vaccine responses in

> elderly adults. J Infect Dis 1998;178:431-40.

>  

> From: pagid-bounces at list.clinimmsoc.org [mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Desa Lilic

> Sent: Friday, April 01, 2011 9:23 AM

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

> Subject: Re: [CIS-PAGID] Pneumovax 23 in older adults

>  

> Joe

> You might find this useful

> regards

> Desa

>  

> Desa Lilic MD MSc PhD FRCPath

> Consultant & Clin Sen Lecturer in Immunology, Newcastle University, UK

> tel: ++ 44 (0)191 222 7244

> fax: ++ 44 (0)191 222 5455

> email: desa.lilic at ncl.ac.uk

> 

>  

>  

> From: pagid-bounces at list.clinimmsoc.org [mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Church, Joseph

> Sent: 23 March 2011 23:30

> To: pagid at list.clinimmsoc.org

> Subject: [CIS-PAGID] Pneumovax 23 in older adults

> 

> Colleagues:

>  

> Can any one provide a good reference for the immunogenicity of Pneumovax 23 in persons over 65yo?

>  

> There are lots of trials/studies looking at epidemiology and protection, but I would like to know what the normal responses are for older adults. 

>  

> Thanks.

>  

> Joe Church

> Children’s Hospital Los Angeles

> 

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