[CIS-PAGID] Duration of treatment for Crohn's in XLA

[Richard Wasserman]

No. Just IVIG.
Richard
On Saturday, May 21, 2011, Baxi, Sachin
<Sachin.Baxi at childrens.harvard.edu> wrote:

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> Thank you for the feedback.  Do you add

> any prophylactic medication while on immunosuppression?

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> Sachin

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> From:

> pagid-bounces at list.clinimmsoc.org [mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Richard Wasserman

> Sent: Friday, May 20, 2011 11:54

> PM

> To: pagid at list.clinimmsoc.org

> Subject: Re: [CIS-PAGID] Duration

> of treatment for Crohn's in XLA

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> I agree with Mary Ellen except that the choice between Asacol and

> Pentasa is influenced by the location of maximum disease.

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> Richard Wasserman

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> On Fri, May 20, 2011 at 5:08 PM, Conley, Mary Ellen <maryellen.conley at stjude.org>

> wrote:

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> I would guess that about 5% of patients

> with XLA have a GI disease that is like IBD.  Often the symptoms are

> preceded by an infection, but not always.  Like Richard Wasserman, we have

> found that steroids and 6MP or Immuran have been successful. Asacol is low risk

> and the GI doctors like it and so do I.  We have often added Flagyl,

> even when there is no documented infection.  It seems to help.

> People are often reluctant to use adequate doses of steroids.  We go for 2

> mg/kg prednisone and taper very slowly to an alternate day dose.  We don't

> try to taper them off for several years.  We have used parenteral

> nutrition in our sickest patient.  We have had relapses too.  Again,

> often preceded by an infection (giardia is the worst culprit!)

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> We stay away from TNF inhibitors.  They seem to cause more problems.

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> Mary Ellen

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> Mary

> Ellen Conley, MD

> Department

> of Immunology/ Mail Stop 351

> St.

> Jude Children's Research Hospital

> 262

> Danny Thomas Place

> Memphis,

> TN 38105-3678

> FAX

> 901-595-3977

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> TEL

> 901-595-2576

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> From: pagid-bounces at list.clinimmsoc.org

> [mailto:pagid-bounces at list.clinimmsoc.org]

> On Behalf Of Richard Wasserman

> Sent: Friday, May 20, 2011 4:43 PM

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> To: pagid at list.clinimmsoc.org

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> Subject: Re: [CIS-PAGID]

> Duration of treatment for Crohn's in XLA

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-- 
Richard L. Wasserman, MD, PhD
DallasAllergyImmunology
7777 Forest Lane, Suite B-332
Dallas, Texas 75230
Office (972) 566-7788
Fax (972) 566-8837
Cell (214) 697-7211