[CIS PIDD] [cis-pidd] Milder CVID phenotype with pregnancy

[Zachary D. Jacobs, MD]

Dear Colleagues,

I am following a 34 year old woman with a milder CVID phenotype
characterized by an IgG in the mid 400s, IgA in the 30s, normal IgM and a
moderate specific antibody deficiency with pre/post Pneumovax testing.  Her
pattern of infections has not been that bad at all and since her diagnosis
about 18 months ago we have just been watching her and she has doing really
well just with expectant/supportive therapy - no supplemental
immunoglobulin.

She is now 21 weeks pregnant and still doing well. However, I was wondering
if it might be beneficial to give her 1-2 doses of IVIG in the third
trimester leading up to birth to optimize passive transfer of IgG to the
baby, thinking that it might be better off for the infant to have a more
"normal"  IgG at birth so the physiologic nadir won't hit rock bottom with
him/her.

Any thoughts or experience with this scenario would be appreciated.

Thanks as always.

Zach

-- 
Zachary D. Jacobs, M.D.

The Center for Allergy & Immunology

Kansas City Physician Partners
Medical Plaza II
4330 Wornall, Suite 40
Kansas City, MO 64111

Ph: 816.531.0930
Fax: 816.753.2671

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