[CIS PIDD] [cis-pidd] 14yo with recurrent Staph aureus sepsis

Church, Joseph JChurch at chla.usc.edu
Wed Jun 4 15:00:32 EDT 2014


I know of no clinical lab doing anti-cytokine autoantibody testing.

I have sent anti-IFNgamma to Sarah at NIH.  Anne Puel in Paris does anti-IL17/IL22 and, I think still offers anti-IL6.

JC

From: Jason Raasch [mailto:jraasch at midwestimmunology.com]
Sent: Wednesday, June 04, 2014 11:53 AM
To: CIS-PIDD
Subject: Re: RE: [cis-pidd] 14yo with recurrent Staph aureus sepsis

Nima,

I think this is a good consideration but a practical question is where to have this done in the U.S.  Sarah Browne discussed cytokine antibodies at CIS 2014 but I believe part of the talk was measuring these is largely on an investigational basis at the NIH.

Joe and others: are you aware of anywhere else to assess for cytokine Ab's?

-J



Jason Raasch, MD

Midwest Immunology Clinic
15700 37th Ave N, Ste 110
Plymouth, MN 55446

TEL: (763) 577-0008
FAX: (763) 577-0192







On 6/3/14 11:20 AM, Nima Parvaneh wrote:



Dear Joe,

Did you check the anti-IL6 autoantibodies. as the patient had a normal past medical history during the early years, he most probably have an acquired condition. Please see the following ref:

Recurrent staphylococcal cellulitis and subcutaneous abscesses in a child with autoantibodies against IL-6.<http://www.ncbi.nlm.nih.gov/pubmed/18097067> J Immunol. 2008 Jan 1;180(1):647-54



Yours,

nima.





On 2014-06-03 17:59, Church, Joseph wrote:
His skin is normal, no eczema, fungal infections, warts etc.  IgE is pending; no eosinophilia.  JC

From: Heimall, Jennifer [mailto:heimallj at email.chop.edu]
Sent: Monday, June 02, 2014 8:17 PM
To: CIS-PIDD
Subject: Re: [cis-pidd] 14yo with recurrent Staph aureus sepsis

Any other history of eczema, fungal infection or warts?  Any elevation in ige or eosinophilia? I am thinking of perhaps a DOCk8- some were not too sick until their teens.
Jen

Sent from my iPhone

On Jun 2, 2014, at 7:56 PM, "Church, Joseph" <JChurch at chla.usc.edu<mailto:JChurch at chla.usc.edu>> wrote:
Colleagues:

I was asked to evaluate a previously very healthy 14yo boy who experienced the following:

*         2012 Cellulitis (likely Staph) after an insect bite

*         2013 Staph aureus, methicillin sensitive, septic shock after minor skin trauma and possible local infection

*         2014 Staph aureus, methicillin sensitive, sepsis.

He has a past history of a 4mm VSD, but echocardiography on two occasions failed to reveal a focus of infection.

Neutrophil counts were repeatedly normal.

Physical exam is normal except for a III/VI ejection murmur.

I have never read that CGD or LAD presents like this.  I plan to suggest a closer look at his heart valves.  Any other suggestions?

Joe Church
Children's Hospital Los Angeles

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--



Nima Parvaneh, MD.

Assistant Professor

Department of Pediatrics

Division of Allergy and Clinical Immunology

Tehran University of Medical Sciences

62 Gharib St, 14194 Tehran, Iran

Tel: +98-21-66920982

Fax: +98-21-66923054

Email: nparvaneh at tums.ac.ir<mailto:nparvaneh at tums.ac.ir>

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