[CIS PIDD] [cis-pidd] question about dysuria in a CVID patient

[Oscar de la Calle-Martín]

Yes, I agree with Dr. Vasconcelos. She seems affected with a more
complicated disease than CVID or even an AR agammaglobulinemia.

Oscar de la Calle


2013/6/10 <dmvascon at usp.br>


> Hi Yae-Jean

>

> She seems too sick for a CVID patient.

> Did you check for a possible STAT5b mutation? Maybe ADA deficiency?

> Does she have autoantibodies? Does she present any bladder malformation?

> granulomas?

> What about the possibility of a mycobacteriosis?

>

> Best,

>

> Dewton

>

> Dewton de Moraes Vasconcelos, MD; PhD

> University of São Paulo School of Medicine

>

>

> ------------------------------

>

> *De: *"YaeJean Kim" <yaejeankim at skku.edu>

> *Para: *"CIS-PIDD" <cis-pidd at lists.clinimmsoc.org>

> *Enviadas: *Segunda-feira, 10 de Junho de 2013 11:52:26

> *Assunto: *[cis-pidd] question about dysuria in a CVID patient

>

>

> Dear All,

>

> I have a 14 yo girl with CVID on IVIG replacement therapy every 3 weeks.

> She has multiple conditions as below.

> - s/p CMV infection diagnosed at outside hospital.

> - A huge splenomegaly for which she received splenectomy -> amoxacillin

> prophylaxis

> - Chronic kidney disease stage 4

> - Hypertension

> - Short stature, delayed puberty

> - interstitial pneumonitis responded to steroid and now off

>

> The reason that I am writing is about *significant dysuria and urinary

> frequency*. Multiple urine cultures did not grow anything.

> But she complains of severe waxing and waning pain.

>

> This time, she was rolling in the bed because of pain in the suprapubic

> area/perineum and fever. At ER, UA showed LE+++, numerous WBC/ HPF but gram

> stain and routine urine culture grew nothing. Cefotaxime was started

> empirically and the fever is gone, the pain is reduced (I am not sure

> whether it was truly due to cefotaxime effect or not)...Anyway, she got

> somewhat better but still complains of sudden pain that requires pain meds

> on and off.

> Image studies showed no definite stones..

>

> Urology and nephrology have seen her but no clear idea. To her, this is a

> significant symptom that bothers her daily life.

> At this point, I would appreciate any suggestion or advice.

>

> Sincerely,

>

> YaeJean

>

> -------------------------------------------------

> Yae-Jean Kim, MD, PhD

> Associate Professor

> Division of Infectious Diseases

> Department of Pediatrics

> Sungkyunkwan University School of Medicine

> Samsung Medical Center

> 50 Irwon-dong Gangnam-gu

> Seoul, Korea

> Tel)  +82-2-3410-3539, 0987  Fax) +82-2-3410-0043

> yaejeankim at skku.edu

>

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-- 
--------------------------------------------------------------------------------------------------------------------------

Dr. Oscar de la Calle-Martín
Laboratoris, Planta -2, Bloc B,
Servei d'Immunologia, Hospital de Sant Pau
C/ San Quintin 89, E-08041 Barcelona, SPAIN
MOVIL SANT PAU 37386 / 682 745 510
93 553 7265 (SECRETARIA), 93 553 7386 / 93 553 7546 (DESPACHO)
odlcalle at gmail.com

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