[CIS PIDD] [MARKETING][cis-pidd] Patient with reduced immunoglobulin levels and multiple sclerosis

[CIS-PIDD]

She needs to have her Pneumovax vaccine responses studied: Does she have hypogammaglobulinemia or antibody deficiency?

Polysaccharide vaccines are safe to use in MS.

Mikko

Oyl Mikko Seppänen
Harvinaissairauksien yksikkö (HAKE)

Chief, Rare Disease Center,
Helsinki University Hospital (HUH)
FINLAND

phone +358 947180201
GSM +358 50 4279606
fax +358 9 47174703

CIS-PIDD <cis-pidd at lists.clinimmsoc.org<mailto:cis-pidd at lists.clinimmsoc.org>> kirjoitti 28.10.2015 kello 13.16:

Hi all,

I have seen a patient with slightly reduced immunoglobulin levels (IgG 422 mg/dl; IgA 54 mg/dl; IgM 56 mg/dl) and remitting relapsing multiple sclerosis for the last 20 years. She herself has no history of severe or increased infection, and her levels of T cells, B cells/memory B cells and Nk cells are normal. She has two sons. Both of them have similarly reduced immunoglobulin levels and one of them suffers from recurrent fevers (most of the time without a defined infectious cause) and has been put on IvIg about 2 years ago with a clear benefit concerning his fevers and well being.

The patient has been treated so far for her MS mainly with steroids (Interferon, Azathioprin, Dimethylfumerat have been tried but were all not tolerated by the patient and stopped after short treatment periods).


Do you think that treating her with scIgG/ivIG Immunoglobulins would help her concerning her MS?

Would you also think treating her with Natalizumab (she is JC-Antibody positive) would mean a not-recomendable risk in her situation?

Would you think treating her with Fingolimod would be worth a try without putting her under to much risk?

Thank you for your experience/recommendations!

Simon

--
Prof. Dr. Simon Rothenfusser
Klinikum der Universität München
Division of Clinical Pharmacology
Department of Medicine IV
Lindwurmstr. 2a, 80337 Munich

E-mail: Simon.rothenfusser at med.uni-muenchen.de<mailto:Simon.rothenfusser at med.uni-muenchen.de>
www.klinische-pharmakologie.de<http://www.klinische-pharmakologie.de>





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