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

[Cooper, Megan]

Hi Jane - for otherwise healthy pts we usually try colchicine 1st and then sometimes low dose cyclosporine if that isn't working.  We have one refractory pt who responded to Imuran for a while and subsequently anti-TNF therapy.

Any evidence of IBD?

Megan

Megan Cooper, MD, PhD
Washington University
Dept. of Pediatrics
Div. of Rheumatology

On Jun 5, 2014, at 1:23 AM, "Jane Peake" <j.peake at uq.edu.au<mailto: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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