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

[Nacho Gonzalez]

The European experience has been recently collected and published this year
in JCI (PMID: 25663093). No patient received IVIG (as has been said, it has
no sense). 68% of them received prophylactic antibiotics (physicians in the
UK were more likely to prescribe antibiotic prophylaxis than colleagues on
the Continent for patients with classical pathway defects). Perhaps Peter
Arkwright (colleagues from Manchester collected the data) may explain
specifically the EU approach concerning C2 def patients. Vaccines are the
cornerstone for the prophylaxis in these patients.

Luis Ignacio Gonzalez Granado
Immunodeficiencies Unit
Pediatrics
Hospital 12 octubre. Madrid. Spain

2015-04-14 16:58 GMT+02:00 Saxon, Andy M.D. <ASaxon at mednet.ucla.edu>:

>  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
> <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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