[CIS PIDD] [cis-pidd] Subcutaneous Plaques following immunoglobbulin infusions

[Kobrynski, Lisa]

We have had three patients develop ulcerative lesions which become indurated but not painful and have occurred sporadically. I agree that one concern I had was that the infusion was given intradermally. But I would expect that to be painful.
I also have several patients develop nonpainful SC nodules (3-5mm) after infusion with the 20% product which resolve after a few weeks. I have not had anyone complain of this with the 10% product.
You might consider doing a biopsy of the lesion to see what kind or tissue reaction is occurring.
Lisa Kobrynski

Sent from my iPhone

On Jun 13, 2013, at 4:56 PM, "Richard Wasserman" <drrichwasserman at gmail.com<mailto:drrichwasserman at gmail.com>> wrote:

I take care of a teenage ADA deficiency SCID patient who developed subcutaneous nodules, indurated 2cm masses without overlying discoloration, when he began treatment with the 20% product. They have been slow to resolve. He is tolerating the low infusion site reaction 10% product without problems.

Are you confident that these infusion were subcutaneous and not intradermal?
Richard Wasserman


On Wed, Jun 12, 2013 at 9:33 PM, Heimall, Jennifer <heimallj at email.chop.edu<mailto:heimallj at email.chop.edu>> wrote:

I have an 18y/o patient with specific antibody deficiency who was treated with subcutaneous immunoglobulin replacement.  After about 10 months, she developed painful nodules on the left flank.  We encouraged rotation of infusion sites and tried a change of product.

Despite these changes and having been off of subcutaneous immunoglobulin for the last 2 months, she now has large (11cmx6cm), tender, firm plaques with overlying hyperpigmentation present on both sides of her lower abdomen.

Has anyone else encountered this with patients on subcutaneous immunoglobulin?







Jennifer Heimall, MD
The Children's Hospital of Philadelphia
Allergy/Immunology
3550 Market Street
3rd Floor
Philadelphia, PA 19104
phone: (267)426-9231<tel:%28267%29426-9231>

---

The CIS-PIDD listserv is supported by:

[cid:]
The science & practice of human immunology

P: +1.414.224.8095<tel:%2B1.414.224.8095>
E: info at clinimmsoc.org<mailto:info at clinimmsoc.org>

Not a member of CIS? Please visit www.clinimmsoc.org<https://cis.execinc.com/edibo/Signup> to join!

You are currently subscribed to cis-pidd as: drrichwasserman at gmail.com<mailto:drrichwasserman at gmail.com>.
To unsubscribe click here: http://lm.clinimmsoc.org/u?id=183824791.4055848875ac55142db7b13469f6d1ab&n=T&l=cis-pidd&o=43474664



--
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

---

The CIS-PIDD listserv is supported by:

[http://www.clinimmsoc.org/UserFiles/image/cis-pidd-list-logo_v1.jpg]
The science & practice of human immunology

P: +1.414.224.8095
E: info at clinimmsoc.org<mailto:info at clinimmsoc.org>

Not a member of CIS? Please visit www.clinimmsoc.org<https://cis.execinc.com/edibo/Signup> to join!

You are currently subscribed to cis-pidd as: lkobryn at emory.edu<mailto:lkobryn at emory.edu>.
To unsubscribe click here: http://lm.clinimmsoc.org/u?id=183824542.3201f5eed0ab3c3c73bfa5803d66dafd&n=T&l=cis-pidd&o=43477864

________________________________

This e-mail message (including any attachments) is for the sole use of
the intended recipient(s) and may contain confidential and privileged
information. If the reader of this message is not the intended
recipient, you are hereby notified that any dissemination, distribution
or copying of this message (including any attachments) is strictly
prohibited.

If you have received this message in error, please contact
the sender by reply e-mail message and destroy all copies of the
original message (including attachments).

---
The CIS-PIDD listserv is supported by the Clinical Immunology Society
The science & practice of human immunology

P: +1.414.224.8095
E: info at clinimmsoc.org

Not a member of CIS? Please visit www.clinimmsoc.org to join!

You are currently subscribed to cis-pidd as: pagid at list.clinimmsoc.org.
To unsubscribe click here: http://lm.clinimmsoc.org/u?id=183939985.3ea13d40a15475ac00ebbd9cd8a37d6d&n=T&l=cis-pidd&o=43480084
or send a blank email to leave-43480084-183939985.3ea13d40a15475ac00ebbd9cd8a37d6d at lists.clinimmsoc.org
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://seven.pairlist.net/pipermail/pagid/attachments/20130614/f96c7001/attachment.htm>