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

Thu Jun 5 09:57:55 EDT 2014

We have a similar patient with Hyper IgM syndrome and neutropenia, responding well to Neupogen but continues with persistent severe apthous stomatitis. Any suggestions?

Thanks,

Jennifer Leiding

________________________________
From: Elie Haddad [elie.haddad at umontreal.ca]
Sent: Thursday, June 05, 2014 9:08 AM
To: CIS-PIDD
Subject: Re: [cis-pidd] Severe aphthous ulcers in an adolescent with CVID

Interesting.
Jane, did you try Colchicine ?
Elie

Elie Haddad, MD, PhD,
Professor of Pediatrics, University of Montreal,
Head, Pediatric Immunology and Rheumatology Division,
CHU Sainte-Justine, 3175 Cote Sainte-Catherine
Montreal, QC, H3T 1C5, Canada
Ph: 1 514 345 4713
fax: 1 514 345 4897
e-mail: elie.haddad at umontreal.ca<mailto:elie.haddad at umontreal.ca>

Le 2014-06-05 à 09:01, Monica Lawrence a écrit :

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<mailto:ml4nz at virginia.edu>

On Jun 5, 2014, at 2:21 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

---

The CIS-PIDD listserv is supported by:

[http://www.clinimmsoc.org/UserFiles/image/cis-pidd-list-logo_v1.jpg]
The science & practice of human immunology

P: +1.414.224.8095
E: info at clinimmsoc.org<mailto:info at clinimmsoc.org>

Not a member of CIS? Please visit www.clinimmsoc.org<https://cis.execinc.com/edibo/Signup> to join!

You are currently subscribed to cis-pidd as: ml4nz at cms.mail.virginia.edu<mailto:ml4nz at cms.mail.virginia.edu>.
To unsubscribe click here: http://lm.clinimmsoc.org/u?id=204824121.500b60ece173df880e0ef202f0fcde4a&n=T&l=cis-pidd&o=44974894

---

The CIS-PIDD listserv is supported by:

[http://www.clinimmsoc.org/UserFiles/image/cis-pidd-list-logo_v1.jpg]
The science & practice of human immunology

P: +1.414.224.8095
E: info at clinimmsoc.org<mailto:info at clinimmsoc.org>

Not a member of CIS? Please visit www.clinimmsoc.org<https://cis.execinc.com/edibo/Signup> to join!

You are currently subscribed to cis-pidd as: elie.haddad at umontreal.ca<mailto:elie.haddad at umontreal.ca>.
To unsubscribe click here: http://lm.clinimmsoc.org/u?id=183824491.f3535596491070e4098b844d5c8444d1&n=T&l=cis-pidd&o=44975743

---

The CIS-PIDD listserv is supported by:

[http://www.clinimmsoc.org/UserFiles/image/cis-pidd-list-logo_v1.jpg]
The science & practice of human immunology

P: +1.414.224.8095
E: info at clinimmsoc.org

Not a member of CIS? Please visit www.clinimmsoc.org<https://cis.execinc.com/edibo/Signup> to join!

You are currently subscribed to cis-pidd as: jleiding at health.usf.edu<mailto:jleiding at health.usf.edu>.
To unsubscribe click here: http://lm.clinimmsoc.org/u?id=183832382.426f03a6f6c3d07c2eb229432b0e19e5&n=T&l=cis-pidd&o=44975776

---
The CIS-PIDD listserv is supported by the Clinical Immunology Society
The science & practice of human immunology

P: +1.414.224.8095
E: info at clinimmsoc.org

Not a member of CIS? Please visit www.clinimmsoc.org to join!

You are currently subscribed to cis-pidd as: pagid at list.clinimmsoc.org.
To unsubscribe click here: http://lm.clinimmsoc.org/u?id=183939985.3ea13d40a15475ac00ebbd9cd8a37d6d&n=T&l=cis-pidd&o=44975903
or send a blank email to leave-44975903-183939985.3ea13d40a15475ac00ebbd9cd8a37d6d at lists.clinimmsoc.org
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://seven.pairlist.net/pipermail/pagid/attachments/20140605/4265cd93/attachment-0001.html>