[CIS PIDD] [cis-pidd] 13 y/o female with SJS secondary to mycoplasma

[dmvascon at usp.br]

Dear Sara 

I think that in the case of a child presenting HUS it is important to rule out defects of complement pathway (C3, factor I, H, B and CD46) and their phenocopies (antibodies against factor B and H are also associated with HUS). There are some few cases of inborn errors of cobalamin C. 
Moreover, besides infectious triggers (E.coli, S. pneumoniae, HIV etc.), autoimmunity (such as SLE, anti phospholipid Ab) are also possibly involved in HUS. 
Thinking in the context of M. pneumoniae infection that can induce IgM Ab to I antigen of red blood cells (sometimes with cryoagglutinin features) it is important to think in the possibility of Mycoplasma infection triggering of a new HUS in the patient, besides SJS. It's not uncommon to observe patients with SJS evolving to renal failure due to dehydration or immune complex deposition in renal glomeruli . 

Therefore I would look at this patient closely in order to exclude other risk factors to develop "autoimmune" manifestations. 

Hope it helps. 

Best regards, 

Dewton 

Dewton de Moraes Vasconcelos , MD, PhD 
Department of Dermatology 
University of São Paulo School of Medicine 
São Paulo, Brazil 

----- Mensagem original -----


> De: "Sara Anvari," <sanvari at cmh.edu>

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

> Enviadas: Quinta-feira, 16 de Janeiro de 2014 13:51:20

> Assunto: [cis-pidd] 13 y/o female with SJS secondary to mycoplasma



> Dear all,



> Wondering if someone out there might have had experience with a case

> similar to this (see below) and could offer us some additional

> direction...



> We have a 13 y/o female patient who was recently admitted for Stevens

> Johnson Syndrome that was triggered by a Mycoplasma pneumonia e

> infection. The patient's past medical history is only significant

> for an episode of hemolytic uremic syndrome at 4 years of age,

> otherwise no history of any underlying medical conditions.



> The parent was concerned about her daughter's risk of recurrence and

> was wanted to know if there was a test to identify if she were at

> higher risk for recurrence of SJS with mycoplasma and if there was

> anything the patient could take prophylactically to help prevent a

> recurrence. At this time, we know there is some risk of recurrence

> of SJS with mycoplasma and we were wondering if anyone may have had

> a case similar to this and if they could share their insight and

> experiences with us.



> We greatly appreciate any help or insights anyone can offer.



> Best regards,



> Sara



> Sara Anvari, MD

> Fellow

> Division of Allergy/Asthma/Immunology

> Children's Mercy Hospital and Clinics

> 2401 Gillham Road

> Kansas City, MO 64108

> Phone: (816) 960-8885

> Fax: (816) 960-8888



> Electronic mail from Children's Mercy Hospitals and Clinics. This

> communication is intended only for the use of the addressee. It may

> contain information that is privileged or confidential under

> applicable law. If you are not the intended recipient or the agent

> of the recipient, you are hereby notified that any dissemination,

> copy or disclosure of this communication is strictly prohibited. If

> you have received this communication in error, please immediately

> forward the message to Children's Mercy Hospital’s Information

> Security Officer via return electronic mail at

> informationsecurityofficer at cmh.edu and expunge this communication

> without making any copies. Thank you for your cooperation.



> ---

> The CIS-PIDD listserv is supported by:



> 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: dmvascon at usp.br .

> To unsubscribe click here:

> http://lm.clinimmsoc.org/u?id=183824445.7c17faf92455fedf52e07cbdec8fae72&n=T&l=cis-pidd&o=44393176

---
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=44394274
or send a blank email to leave-44394274-183939985.3ea13d40a15475ac00ebbd9cd8a37d6d at lists.clinimmsoc.org
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://seven.pairlist.net/pipermail/pagid/attachments/20140116/1faa8110/attachment-0001.html>