[CIS-PAGID] Patient with Selective Antibody deficiency and autoimmune disorder

[Church, Joseph]

Colleagues:

I have followed a 40yo woman with selective antibody deficiency for several months.  Despite excellent IgG levels on Hizentra (>2000mg/dL) she continues to have recurrent, but non-serious URIs.

Her rheumatologist sees her for an undefined inflammatory process, perhaps RA or evolving SLE.  He wishes to treat the patient with a TNF blocker or Imuran, but is concerned about the potential for increased risk for serious infections because of the patient's antibody deficiency.

My sense is that the patient's antibody deficiency is well covered by the Hizentra and that the risk for infection is perhaps marginally increased over the usual risks with these agents.

I would very much appreciate your thoughts on this issue.

Joe Church
Children's Hospital Los Angeles




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