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

[Riedl, Marc]

ESR and CRP have been normal as has her white count.   Haven't done advanced complement studies though immune complexes have been negative to date.

Thanks for the other reports of seizure issues.


Marc Riedl, M.D., M.S.
Assistant Professor of Medicine
Section Head, Clinical Immunology and Allergy
UCLA - David Geffen School of Medicine



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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