[CIS PIDD] [cis-pidd] SubQ first dose

[Seppänen Mikko]

Dear Kate and all,

we do the same as Madrid (except that we give 2 loading doses 2 days apart if patient in poor condition at dg, if not we go straight to training for SCIg), adult patients, and no home team to back us up.

With the experience of >200 patients trained, serious side effects once in CVID-like condition (not classical, probably an non-described combined PIDD) during training, and 2-3 times due to incorrect diagnosis (the other I remember had vitamin A def the other B12 def and neither had SAD in retesting after supplementation). Thus if dg accurate, true PAD, very low risk, especially if clear cut case.

mikko

__________________________________________________
Mikko Seppänen, MD, PhD, Docent (Associate professor/Senior Lecturer)
Specialist in Internal Medicine and Infectious Diseases
Senior Consultant, Physician in charge (PIDD)
EM(E)A Expert, PIDDs and Intravenous Immunoglobulin Therapy

Immunodeficiency Unit
Division of Infectious Diseases
Department of Medicine
Helsinki University Central Hospital
Hospital District of Helsinki and Uusimaa
Aurora Hospital, Ward 4-2 and Outpatient Clinic
P.O.Box 348
FI-00029 HUS, Helsinki
FINLAND
phone +358 9 47175923, fax +358 9 47175945
_________________________________________



Lähettäjä: Nacho Gonzalez [mailto:nachgonzalez at gmail.com]
Lähetetty: 23. toukokuuta 2013 22:34
Vastaanottaja: CIS-PIDD
Aihe: RE: [cis-pidd] SubQ first dose


Dear all,

In our centre we do the same.first loading dose ivig. Next 2-3 sc doses at the office(training programme).26 patients.No systemic effects reported to date. We do not provide epinephrine as UK people do.

Best regards

Luis Ignacio Gonzalez Granado
Immunodeficiencies.Pediatrics
Hospital 12 octubre.
Madrid.Spain
El 23/05/2013 21:21, "Church, Joseph" <JChurch at chla.usc.edu<mailto:JChurch at chla.usc.edu>> escribió:
Kate:

Usually I try to give a single 'loading' dose of IVIG In clinic prior to initiating SCIG at home 1 week later.

For patients directly starting SCIG I try to give the first dose in clinic, with the home infusion team there.  It seems to ease parents' anxiety.

For other patients going directly to SCIG I may give the first and all doses at home, depending on family.

JC

-----Original Message-----
From: Sullivan, Kathleen [mailto:sullivak at mail.med.upenn.edu<mailto:sullivak at mail.med.upenn.edu>]
Sent: Thursday, May 23, 2013 12:14 PM
To: CIS-PIDD
Subject: [cis-pidd] SubQ first dose

Question to all...

It has been our tradition to always give a first dose of any new immunoglobulin product under medical supervision (i.e. not at home).   I wonder how many people do that for subcutaneous products though.  I think the risk of a reaction that needs medical attention is very low.

What do all of you do?

Kate
Kate Sullivan, MD PhD
Professor of Pediatrics
ARC 1216 Immunology CHOP
3615 Civic Center Blvd.
Philadelphia, PA 19104
(p) 215-590-1697
(f) 267-426-0363



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