[CIS PIDD] [cis-pidd] Severe aphthous ulcers in an adolescent with CVID

[Monica Lawrence]

Hi Jane,

We recently submitted a case report of using high dose (1-2 g/kg/month) IVIG successfully for the treatment of refractory recurrent aphthous stomatitis in a previously steroid-dependent 3 year old boy (without CVID/other immunodeficiency).   He had difficulty tolerating the high dose IVIG so we switched to SCIG (250 mg/kg/week) and he has been successfully maintained on this therapy for >1 year now without need for any other therapy.   So, you may try increasing the dose/frequency of your IVIG and see if the ulcers also improve.

Best,

Monica G. Lawrence, MD
Assistant Professor of Medicine
Department of Medicine
Division of Asthma,Allergy & Immunology
University of Virginia
PO Box 801355
Charlottesville, VA 22908
434-243-6811
ml4nz at virginia.edu







On Jun 5, 2014, at 2:21 AM, Jane Peake <j.peake at uq.edu.au> wrote:

> Hi all
> I have a young girl with CVID who has been plagued with severe disabling aphthous ulcers for many years. Since starting on IVIg her infectious problems have largely resolved and her ulcers are better but they are still problematic. She gets them on her tongue, buccal mucosa and roof of the mouth and when she has them she finds eating and speech very difficult. Episodes are intermittent but she rarely goes more than a couple of weeks without a severe episode. She has had a couple of episodes of labial lesions but since starting doxycycline (on the advice of the gynaecologists) she has only had one episode when they had run out of the doxycycline. We have tried a variety of topical treatments – local anaesthetics and steroids. She responds well to oral steroids but these cannot be used regularly. Does anybody have any other ideas in this setting?
> Thanks for any suggestions
> Cheers Jane
>  
> Dr Jane Peake
> Paediatric Immunologist and Allergist
> Senior Lecturer
> University of Queensland
> level 3 Foundation Building
> Royal Children's Hospital
> Herston Rd, Herston QLD 4029
>  
>  
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