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

[Patsy Giclas]

On the same track, is there evidence of complement activation (i.e. C3a, C4a
or C4d)?

Patsy

---------------------------------------------------------
Patricia C. Giclas. Ph.D.
Director, Complement Laboratory
Advanced Diagnostic Laboratories
Professor, Pediatrics Dept,  Allergy and Immunology Division
National Jewish Health
1400 Jackson St., Denver, CO 80206 U.S.A.

Office: D409, Neustadt Building
Phone: 303-398-1217
Fax: 303-270-2128
Email: giclasp at njhealth.org



> From: "Berger, Melvin" <Melvin.Berger at UHhospitals.org>

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

> Date: Sat, 16 Apr 2011 22:18:09 -0600

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