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

[Church, Joseph]

Thank you all for your comments and suggestions.

 

Mel:  I have not done these, but I will now.  

 

JC

 

________________________________

From: pagid-bounces at list.clinimmsoc.org
[mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Berger, Melvin
Sent: Saturday, April 16, 2011 9:18 PM
To: pagid at list.clinimmsoc.org
Subject: RE: [CIS-PAGID] CVID Pt wheezes 12h after Hizentra

 

Joee, Marc- What is the  ESR and CRP before infusions, and white count
after vs before of the patients with flu-like or chet symptoms after
SCIG ? 

 

Melvin Berger, M.D., Ph.D.

Adjunct Professor of Pediatrics and Pathology

Case Western Reserve University

Cleveland, OH 44106

 

________________________________

From: pagid-bounces at list.clinimmsoc.org on behalf of Riedl, Marc
Sent: Sat 4/16/2011 3:51 PM
To: pagid listserve
Subject: Re: [CIS-PAGID] CVID Pt wheezes 12h after Hizentra

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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