[CIS PIDD] [cis-pidd] IVIG/ScIg for Complement deficiency?

Tue Apr 14 11:03:50 EDT 2015

Hi Andy.  Thank you for the kind words.  I have seen 2 primary C2 deficiencies over the past 39 years.  They presented with recurrent S. pneumoniae sepsis, as has been reported.  JC

From: Saxon, Andy M.D. [mailto:ASaxon at mednet.ucla.edu]
Sent: Tuesday, April 14, 2015 7:58 AM
To: CIS-PIDD
Subject: RE: [cis-pidd] IVIG/ScIg for Complement deficiency?

As Joe said, makes no sense.  There is a growing group of less than critical folks who are using IVIG (and charging for it through their practices) for all sorts of inappropriate diagnoses and making "appropriate" diagnoses, e.g. CIDP) with little basis so as to give IVIG as a revenue stream.

How many cases of real C2 deficiency have you got floating around up there anyway? And I thought the concern was autoimmunity, not infection in real C2 deficiency as opposed to say C8 deficiency. I'd like to hear from some of you great Peds folks in addition to the outstanding Joe Church..

Andy Saxon, MD
Professor of Medicine
UCLA

PS - Hi Joe!

From: Church, Joseph [mailto:JChurch at chla.usc.edu]
Sent: Tuesday, April 14, 2015 7:51 AM
To: CIS-PIDD
Subject: RE: [cis-pidd] IVIG/ScIg for Complement deficiency?

This makes no sense to me.  The patients' problem is not the inability to make antibodies, it is the inability to use complement that is activated by the classical pathway (or lectin pathway) regardless of the source of antibodies.

Joe Church
Children's Hospital Los Angeles

From: Jason Raasch [mailto:jraasch at midwestimmunology.com]
Sent: Monday, April 13, 2015 1:31 PM
To: CIS-PIDD
Subject: [cis-pidd] IVIG/ScIg for Complement deficiency?

Hello everyone.

I have heard of some practitioners in our region using IVIG as sole management for isolated C2 deficiency in infants/children (i.e. instead of prophylactic antibiotics, immunizations for encapsulated organisms, etc.).  The feeling is long-term use of prophylactic antibiotics in these cases is irresponsible.

I will be honest and admit I have not heard of this before or found much in the literature.  What am I missing here?

I would appreciate any comments.

Regards,

Jason

Jason Raasch, MD

Midwest Immunology Clinic
15700 37th Ave N, Ste 110
Plymouth, MN 55446

TEL: (763) 577-0008
FAX: (763) 577-0192

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