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

Wed Jun 4 17:00:10 EDT 2014

Tom,

Thanks so much for that info - very helpful.

Best regards,

Zach

On Wed, Jun 4, 2014 at 3:37 PM, Boyce, Thomas G., M.D. <
Boyce.Thomas at mayo.edu> wrote:

>  Zach,
>
>
>
> Premees are routinely born with very low IgG (maternal transfer does not
> start till around 25-26 weeks’ gestation) and several studies have shown no
> benefit to administering IVIG vs placebo to these infants.
>
>
>
> Tom
>
>
>
>
>
> Thomas G. Boyce, MD, MPH
> Pediatric Infectious Diseases and Immunology
> Mayo Clinic
> Rochester, MN 55905
> phone: 507-255-8464
> fax: 507-255-7767
>
>
>
>
>
> *From:* Zachary D. Jacobs, MD [mailto:zjacobs.md at gmail.com]
> *Sent:* Wednesday, June 04, 2014 3:02 PM
> *To:* CIS-PIDD
> *Subject:* [cis-pidd] Milder CVID phenotype with pregnancy
>
>
>
> 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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-- 
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

 CONFIDENTIALITY NOTICE. This e-mail and attachments (if any) may contain
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