[CIS-PAGID] Stiff Person Syndrome

[Richard Wasserman]

I was asked to see a 12 year old Caucasian female recently diagnosed with
Stiff Person Syndrome.

She had longstanding diagnoses of atypical cerebral palsy and CVID.  She
functioned fairly will with ongoing neurology, immunology, and physical
medicine / rehabilitation specialty care until  May 12, 2010 when she had a
severe reaction to her first infusion of Gamunex (excipient glycine)
characterized by dramatic worsening of neuromuscular symptoms, she had
previously received Octagam. Following this episode, the diagnosis of CP was
reassessed and revised to SPS. Since that time, she has developed
significant worsening of her neuromuscular complaints and dysautonomia.
Autoantibodies, anti-Glutamic Acid Decarboxylase and anti-TPO, have been
detected.


She has failed baclofen, immunomodulatory doses of Gamagard, and
diazepam.She is currently being plasmapharesed. I have suggested
Rituxin.


I don't know the mechanism worsening caused by Gamunex. Any suggestions for
additional studies or alternative therapy?


Thank you,

Richard

-- 
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
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