[CIS-PAGID] CVID Pt wheezes 12h after Hizentra

[Oner Ozdemir]

Hi Dr. Riedl;

When I was a fellow with Dr. Ricardo Sorensen at LSU-HSC; we came across a
similar patient having a seizure-like episode.
At that time, we have even made an abstract of this case to ACAAAI meeting
2005, however it was rejected.
This patient's episodes after SCIG were increased. MRI and EEG at that time
did not show anything.
Later, I could not follow this patient and because of Katrina I left the
program.
I do not know Dr. Sorensen or his current team may say more on this
patient.

Regards;

-- 
Öner Özdemir, MD
Assoc. Prof. Pediatrics
Chief of Pediatrics
İstanbul Göztepe Research and Training Hospital
Göztepe, Kadıköy, İSTANBUL -TÜRKİYE

.....................
On Sat, Apr 16, 2011 at 10:51 PM, Riedl, Marc <MRiedl at mednet.ucla.edu>wrote:


> Joe,

>

> I haven't seen this specific reaction in a relatively large cohort of SQ

> patients.  I have one elderly woman (similar list of chronic issues) who

> consistently develops an intense flu-like syndrome (myalgias, low-grade

> fever, malaise) ~12-24 hours after her SQ infusions, but doesn't appear to

> be product specific.  No wheezing per se.

>

> On a slightly different issue:  Has anyone seen IgG tx (SQ or IV) for PID

> exacerbate an underlying seizure disorder?  This same patient experiences a

> clear increase in seizure frequency temporally associated with her IgG

> therapy.  This was quite dramatic with IV and a major reason for her switch

> to SQ.  She has done better but still has frequent seizures in the hours

> following her SQ infusions requiring more aggressive anticonvulsant therapy.

>

> Interested if anyone has similar experience or ideas on mechanism +

> troubleshooting this.

>

> Best,

>

> Marc

>

> Marc Riedl, M.D., M.S.

> Assistant Professor of Medicine

> Section Head, Clinical Immunology and Allergy

> UCLA - David Geffen School of Medicine

> 10833 Le Conte Ave, 37-131 CHS

> Los Angeles, CA  90095-1680

> Tel 310.206.4345  Fax 310.267.009

>

>

>

>

> From: "Church, Joseph" <JChurch at chla.usc.edu<mailto:JChurch at chla.usc.edu>>

> Reply-To: pagid listserve <pagid at list.clinimmsoc.org<mailto:

> pagid at list.clinimmsoc.org>>

> Date: Fri, 15 Apr 2011 17:48:42 -0700

> To: pagid listserve <pagid at list.clinimmsoc.org<mailto:

> pagid at list.clinimmsoc.org>>

> Subject: [CIS-PAGID] CVID Pt wheezes 12h after Hizentra

>

> Colleagues:

>

> I recently started to follow a 57yo lady with CVID.  She has lots of other

> complaints (fatigue, arthralgias, thyroid disease, migraines,mitral valve

> prolapse…).

>

> She had significant reactions following Vivaglobin: fatigue, nausea, hives.

>

> She is receiving Hizentra.  Approximately 12h after each infusion she

> complains of wheezing.  This is responsive to Xopenex and not of a severity

> to consider discontinuing the infusions.

>

> Has anyone seen this in patients following SCIG?

>

> IgG anti-IgA is pending.

>

> Thank you for your thoughts.

>

> Joe Church

> Children’s Hospital Los Angeles

>

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