[CIS-PAGID] Stiff Person Syndrome

[Elie Haddad]

Richard,
I do agree with your proposition of Rituxan. Also, maybe you should give her subcu-IG instead of IVIG because they induce less systemic reaction and in SPS, systemic reaction (whatever the cause) like any stress may trigger spasms.
Elie


Elie Haddad, MD, PhD;
Professor of Pediatrics, University of Montreal,
Head, Pediatric Immunology and Rheumatology Division,
CHU Sainte-Justine, 3175 Cote Sainte-Catherine
Montreal, QC, H3T 1C5, Canada
Ph: 1 514 345 4713
fax: 1 514 345 4897
e-mail: elie.haddad at umontreal.ca




Le 2011-07-13 à 17:34, Richard Wasserman a écrit :


> 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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