[CIS-PAGID] Stiff Person Syndrome

[Kirkpatrick, Charles]

Richard:

I wonder if the anti-HLA antibodies in the IgG are involved in this?

Chuck Kirkpatrick

From: pagid-bounces at list.clinimmsoc.org [mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Richard Wasserman
Sent: Wednesday, July 13, 2011 3:35 PM
To: PAGID
Cc: Susan Sugerman
Subject: [CIS-PAGID] Stiff Person Syndrome

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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