[CIS PIDD] [cis-pidd] CVID in late pregnancy

[CIS-PIDD]

I saw a 28 year old woman yesterday to counsel about SCID. Her first baby
and multiple congenital anomalies, zero TRECs, profound lymphopenia and
died at a few weeks of age of heart disease and post-op infection. GeneDx
panel of 18 SCID genes was negative. No specific diagnosis.

Current patient is due to deliver in three weeks. Her history includes:
septic arthritis, N. meningitidis meningitis after vaccination, five
episodes of pneumonia including an MRSA and a Klebsiella, multiple episodes
of bronchitis and three episodes of adenopathy sufficient to merit biopsy -
all reactive lymphoid hyperplasia. She has had some evaluation in the past
that is not yet available. She has been said to be vaccine non-responsive.
Her screening studies are:

Immunoglobulin G, Qn, Serum [L]  526 mg/dL   700-1600
Immunoglobulin A, Qn, Serum 129 mg/dL     91-414
Immunoglobulin M, Qn, Serum  [H]  256 mg/dL   40-230

Would you treat her with immunoglobulin prior to delivery?

Thanks,
Richard

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

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