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

[CIS-PIDD]

Hi Mikko, 

She has only hypogammaglobulinemia. Her vaccine titers including pneumokki
were in our interpretation normal responses as were lymphocyte stimulation
tests. 

Simon


Von:  CIS-PIDD <cis-pidd at lists.clinimmsoc.org>
Antworten an:  CIS-PIDD <cis-pidd at lyris.dundee.net>
Datum:  Mittwoch, 28. Oktober 2015 13:10
An:  CIS-PIDD <cis-pidd at lyris.dundee.net>
Betreff:  Re: [MARKETING][cis-pidd] Patient with reduced immunoglobulin
levels and multiple sclerosis

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> 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
> www.klinische-pharmakologie.de <http://www.klinische-pharmakologie.de>
> 
> 
> 
> 
> 
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