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

Fri Jun 6 11:43:42 EDT 2014

Thanks Jason, I was hiking the mountains and out of touch. Obviously,
Debacterol doesn't prevent the problems but seems to hasten resolution of
pain. If the patient is old enough, twice daily swish and spit with OTC
H2O2 mixed 1:1 with water (about 120ml) is cheaper than chlorhexidine mouth
wash and not as bad tasting.

Richard Wasserman

On Fri, Jun 6, 2014 at 7:29 AM, Jason Raasch <jraasch at midwestimmunology.com>
wrote:

>
> Kathy,
>
> Debacterol are swabs containing sulfuric acid and sulphonated phenolics.
> Debacterol.com
>
> In MN, have to call in as an Rx to pharmacy (often they have to look this
> up) but typically considered OTC medication so patients usually pay out of
> pocket.  Pharmacy can quote price.
>
> -J
>
>
> Jason Raasch, MD
>
> Midwest Immunology Clinic
> 15700 37th Ave N, Ste 110
> Plymouth, MN 55446
>
> TEL: (763) 577-0008
> FAX: (763) 577-0192
>
>
>
>
>
>
>
> On 6/5/14 11:10 AM, "Haines, Kathleen M.D." wrote:
>
> Rich:  Never heard of Debacterol before now.  Do you have them come in and
> apply it?  Write a script for it?
>
>
>
> Kathy
>
>
>
> *Kathleen A. Haines, MD*
>
> Section Chief, Pediatric Immunology
>
> Section of Pediatric Rheumatology & Immunology
>
> Hackensack UMC
>
> 30 Prospect Ave.
>
> Hackensack, NJ 07601
>
>
>
> Tel: 551-996-5306
>
> Fax: 201-996-9815
>
> khaines at HackensackUMC.org (*Please note domain change)*
>
>
>
> [image: EmailSignature]
>
>
>
>
>
> *From:* Richard Wasserman [mailto:drrichwasserman at gmail.com]
> *Sent:* Thursday, June 05, 2014 10:08 AM
> *To:* CIS-PIDD
> *Subject:* Re: [cis-pidd] Severe aphthous ulcers in an adolescent with
> CVID
>
>
>
> You might try Debacterol <http://www.debacterol.com/prof_ci.html>. I
> agree with Ken, the lesion should be biopsied.
>
> Richard Wasserman
>
>
>
> On Thu, Jun 5, 2014 at 6:57 AM, Leiding, Jennifer <jleiding at health.usf.edu>
> wrote:
>
> 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
>
>
>
>
>
>
>
>
>
> 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
>
>
>
>
>
>
>
>
>
>
>
>
>
> 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
>
>
>
>
>
> ---
>
> The CIS-PIDD listserv is supported by:
>
>
> *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: 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:
>
>
> *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: 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:
>
>
> *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: 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 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: drrichwasserman at gmail.com.
>
> To unsubscribe click here:
> http://lm.clinimmsoc.org/u?id=183824791.4055848875ac55142db7b13469f6d1ab&n=T&l=cis-pidd&o=44975903
>
>
>
>
>
>
> --
> Richard L. Wasserman, MD, PhD
> DallasAllergyImmunology
> 7777 Forest Lane, Suite B-332
> Dallas, Texas 75230
> Office (972) 566-7788
> Fax (972) 566-8837
> Cell (214) 697-7211
>
> ---
>
> The CIS-PIDD listserv is supported by:
>
>
> *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: khaines at hackensackumc.org.
>
> To unsubscribe click here:
> http://lm.clinimmsoc.org/u?id=183824492.e0ae87127a332a0af3f9a4b61633330c&n=T&l=cis-pidd&o=44975930
>
>  *************************************************************************************************************
> Confidentiality Notice: This email message and any attachments from
> HackensackUMC are confidential and for the sole use of the intended
> recipient. This communication may contain Protected Health Information
> ("PHI"). PHI is confidential information that may only be used or disclosed
> in accordance with applicable law. There are penalties under the law for
> the improper use or further disclosure of PHI. If you are not the intended
> recipient of this email or the employee or agent responsible for delivering
> the communication to the intended recipient, then you may not read, copy,
> distribute or otherwise use or disclose the information contained in this
> message. If you received this message in error, please notify us by
> telephone at 551-996-2000 or by email to Postmaster at HackensackUMC.org Please
> indicate that you were not the intended recipient, and confirm that you
> have deleted the original message. Please do not retransmit the contents of
> the message. Thank you.
> *************************************************************************************************************
> About Hackensack University Medical Center HackensackUMC, a nonprofit
> teaching and research hospital located in Bergen County, NJ, is the largest
> provider of inpatient and outpatient services in the state. It is the
> flagship hospital of the Hackensack University Health Network, one of the
> largest health networks in the state comprised of 1,140 beds, nearly 10,000
> employees and 2,200 credentialed physicians. HackensackUMC was listed as
> the number one hospital in New Jersey and one of the top three New York
> metro area hospitals in the U.S. News & World Report’s Best Hospital
> rankings for 2013-14. It also received 10 national rankings in: Cancer;
> Cardiology & Heart Surgery; Ear, Nose & Throat; Gastroenterology & GI
> Surgery; Geriatrics; Neurology & Neurosurgery; Orthopedics; Pulmonology;
> Urology; and the Joseph M. Sanzari Children’s Hospital ranked as one of the
> Top 50 Best Children’s Hospitals for Neurology and Neurosurgery in the
> 2013-14 Best Children’s Hospitals list. HackensackUMC is among
> Healthgrades® America’s Best 100 Hospitals in 10 different areas – more
> than any other hospital in the nation, is one of Healthgrades America's 50
> Best Hospitals™ for seven years in a row, and received the Healthgrades
> Distinguished Hospital Award for Clinical Excellence™ 11 years in a row.
> The medical center has also been named a Leapfrog Top Hospital, and
> received 19 Gold Seals of Approval™ by the Joint Commission – more than any
> other hospital in the country. It was the first hospital in New Jersey and
> second in the nation to become a Magnet® recognized hospital for nursing
> excellence. HackensackUMC is the Hometown Hospital of the New York Giants
> and the New York Red Bulls, and remains committed to its community through
> fundraising and community events. To learn more, visit:
> www.HackensackUMC.org.
>
> ---
>
> The CIS-PIDD listserv is supported by:
>
>
> *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: jraasch at midwestimmunology.com
> .
> To unsubscribe click here:
> http://lm.clinimmsoc.org/u?id=183824721.ffecac98ebae3cc3c3ba17e837b8e976&n=T&l=cis-pidd&o=44976422
>
> ---
>
> The CIS-PIDD listserv is supported by:
>
>
> *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: drrichwasserman at gmail.com.
> To unsubscribe click here:
> http://lm.clinimmsoc.org/u?id=183824791.4055848875ac55142db7b13469f6d1ab&n=T&l=cis-pidd&o=44980187
>
>

-- 
Richard L. Wasserman, MD, PhD
DallasAllergyImmunology
7777 Forest Lane, Suite B-332
Dallas, Texas 75230
Office (972) 566-7788
Fax (972) 566-8837
Cell (214) 697-7211

---
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=44980433
or send a blank email to leave-44980433-183939985.3ea13d40a15475ac00ebbd9cd8a37d6d at lists.clinimmsoc.org
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://seven.pairlist.net/pipermail/pagid/attachments/20140606/d431e6c7/attachment-0001.html>