[CIS PIDD] MBL deficiency

[Church, Joseph]

Richard:

I have had several patients with MBL deficiency (undetectable at Quest lab).  All were teenagers or younger and I have not given Ig replacement.

I reviewed one paper, don't know if it has been published, where MBL deficiency seemed to be associated with worse infections in patients with specific antibody deficiency.

Consider sending the Quest 23 serotype pneumococcal antibody assay ~3 months after her last antibody measures to get a better picture of the breadth and duration of the patient's seroconversion.

Joe Church

From: pagid-bounces at list.clinimmsoc.org [mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Richard Wasserman
Sent: Thursday, June 21, 2012 12:40 PM
To: PAGID
Subject: [CIS PIDD] MBL deficiency

I am seeing a 43 year old female physician with a lifelong history of recurrent sinusitis, two episodes of pneumonia in the past 10 years that required ICU care (one of which sounds like septic shock), significant post-op MRSA infection after sinus surgery and a large cellulitis after stingray envenomation. Immunoglobulins are normal (IgG >1000), pneumococcal antibody titers (14 serotypes) are strongly positive (12/14 >1ug/ml, 8/14 >5ug/ml). Mannose binding lectin was not detectable.

I know that Dr. Kirkpatrick reported a family treated successfully with IGIV. Are there other suggestions for treatment? Antibiotic prophylaxis?
Richard Wasserman
Dallas

--
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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