[CIS PIDD] [cis-pidd] Nausea with IVIG infusions

[Sorensen, Ricardo]

Did you try different IgIV products?
And when you shifted to SC, did you use the SC product from the same company that produced the IgIV?

Ricardo Sorensen

-----Original Message-----
From: Church, Joseph [mailto:JChurch at chla.usc.edu] 
Sent: Friday, January 25, 2013 8:13 PM
To: CIS-PIDD
Subject: RE:[cis-pidd] Nausea with IVIG infusions

The headaches are less of an issue now.  

It is the nausea that is not well controlled.  

I have discussed daily push administration with her;  she wasn't too interested, but she is due for a visit soon and I will raise the issue again.

Thank you.

JC

-----Original Message-----
From: Keller, Michael D [mailto:KellerMD at email.chop.edu] 
Sent: Friday, January 25, 2013 6:09 PM
To: CIS-PIDD
Subject: RE:[cis-pidd] Nausea with IVIG infusions

Hello sir -

A few thoughts -

-if these are preexisting migraines worsened by Ig (including her most recent nausea), I wonder if daily anti migraine therapy (Beta blocker, topiramate, etc) would be of value -you mentioned that she hated SCIG - do you think that would eliminate the possibility of daily push therapy?

Best regards,
Mike
________________________________________
From: Church, Joseph [JChurch at chla.usc.edu]
Sent: Friday, January 25, 2013 7:26 PM
To: CIS-PIDD
Subject: [cis-pidd] Nausea with IVIG infusions

Colleagues:

I follow a young adult woman with CVID who has had multiple problems, originally severe headaches, with Ig infusions.  We have tried SCIG (hated), IVIG q4 and q2weeks, premedications with iv diphenhydramine and motrin.

Most recently she has done better with regards to headache on a q week schedule with pre-Ig hydration, motrin and iv diphenhydramine, and Maxault prn

Now her complaint is nausea that she states starts soon after the IVIG begins infusing and worsens over the next 12-24 hours despite use of Phenergan (not my Rx) and Zofran.

Any thoughts?

Thanks in advance.

Joe Church
Children's Hospital Los Angeles



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