[CIS-PAGID] Anti-TNF in pt with selective antibody deficiency

[Church, Joseph]

Colleagues:

 

I am following a 12yo girl who has rheumatoid arthritis per our
Rheumatology service.  They are recommending anti-TNF therapy.

 

However, she also has IgA deficiency and selective antibody deficiency
(+ response to 2 of 23 pneumococcal serotypes tested after Pneumovax
immunization.  These were evaluated because of recurrent sinusitis.

 

My bias would be to put her on IVIG or SCID while she is receiving
anti-TNF.  Am I being overly cautious?

 

Thank you for your time.

 

Joe Church

Children's Hospital Los Angeles

 

 



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