[CIS PIDD] [cis-pidd] CVID + "Lupus"

[Anna Huttenlocher, MD]

I would start with plaquenil and then methotrexate.

I had a CVID patient who developed worsening disease on cellcept.

Anna
On Dec 7, 2012, at 5:18 AM, Sullivan, Kathleen wrote:


> I'm a big CellCept fan for lupus but of the three drugs, MTX is the one with the least immune suppression so I might start there.  It does not have a wealth of evidence to support its use specifically for lupus but many rheumatologists will try it.

> 

> Kate

> On Dec 6, 2012, at 9:47 PM, Church, Joseph wrote:

> 

>> Colleagues:

>> 

>> I follow a 40yo woman with fairly typical CVID.  Her rheumatologist diagnosed 'lupus' or 'non-specific connective tissue disease.'

>>  

>> Her chronic joint symptoms, primarily arthralgias, responded dramatically to 30 mg of prednisone per day.  As she tapered the steroid all symptoms returned.

>>  

>> Her rheumatologist indicated he is considering starting her on Benlysta, methotrexate or Cellcept. 

>>  

>> Is there a "lesser evil" among these drugs for a patient with CVID?

>>  

>> JC

>> 

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> 

> Kate Sullivan, MD PhD

> Professor of Pediatrics

> ARC 1216 Immunology CHOP

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