[CIS PIDD] [cis-pidd] recurrent pneumonia

Thu Jun 2 15:38:20 EDT 2016

Okay, so perhaps someone could educate me - I thought a liver-spleen scan using Technetium-99m sulfur colloid was the most commonly used procedure to check for splenic uptake. We are using this procedure together with an abd CT for infants with heterotaxy syndrome and either abdominal situs inversus or situs ambiguus when there is a question of polysplenia/asplenia.

Prescott

T. Prescott Atkinson, MD PhD, Professor and Director
Division of Pediatric Allergy, Asthma & Immunology
University of Alabama at Birmingham
Tel: 205-996-9582
Fax: 205-975-7080

From: CIS-PIDD [mailto:cis-pidd at lists.clinimmsoc.org]
Sent: Thursday, June 02, 2016 10:54 AM
To: CIS-PIDD <cis-pidd at lyris.dundee.net>
Subject: RE: [cis-pidd] recurrent pneumonia

Another way to diagnose functional asplenia is a denatured red cell nuclear scan. There are a few other nuclear med techniques and other options include PET-CT and contrast enhanced ultrasound. I think that nuclear med scans have the most data.

--
Rob Sokolic, MD
Medical Officer
Office of Cellular, Tissue and Gene Therapies
Center for Biologics Evaluation and Research
Food and Drug Administration
White Oak Building 71, Room 5261
10903 New Hampshire Ave
Silver Spring, MD 20993-0002
Robert.Sokolic at fda.hhs.gov<mailto:Robert.Sokolic at fda.hhs.gov>
(240) 402-5564
FAX: (301) 595-1305

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From: CIS-PIDD [mailto:cis-pidd at lists.clinimmsoc.org]
Sent: Thursday, June 02, 2016 3:22 AM
To: CIS-PIDD
Subject: VS: [cis-pidd] recurrent pneumonia

Hi Pere!

this I forgot from my list! Have found it once (would rather insensitively be shown in the blood smear, but no generally available other tests), we even published our case (in Finnish)

Mikko

oyl Mikko Seppänen
Harvinaissairauksien yksikkö (HAKE), HUS

Mikko Seppänen, MD, PhD, Associate professor
Specialist in Internal Medicine and Infectious Diseases
Head, Rare Disease Center, Helsinki University Hospital (HUH)
Children's Hospital, P.O.Box 280
FI-00029 HUS
FINLAND
&
Senior Consultant (PIDD)
Adult Immunodeficiency Unit
Inflammation Center, HUH

phone +358 9 47180201
GSM +358 50 4279606
fax +358 9 47174703

Lähettäjä: CIS-PIDD [mailto:cis-pidd at lists.clinimmsoc.org]
Lähetetty: 1. kesäkuuta 2016 22:37
Vastaanottaja: CIS-PIDD <cis-pidd at lyris.dundee.net<mailto:cis-pidd at lyris.dundee.net>>
Aihe: Re: [cis-pidd] recurrent pneumonia

I would consider functional asplenia.

Best,

Pere.
Pere Soler Palacín, MD, PhD, MSc.[cid:334f635afba41888970309a07ef66edfedc313fd at zimbra]<http://orcid.org/0000-0002-0346-5570>
Pediatric Infectious Diseases and Immunodeficiencies Unit. Hospital Universitari Vall d'Hebron.
Vall d'Hebron Research Institute (VHIR)

Assistant Professor. Universitat Autònoma de Barcelona (UAB)
Pg. de la Vall d'Hebron, 119-129
08035 Barcelona. Spain.
Tel. 0034934893140  /  Fax 0034934893039

psoler at vhebron.net<mailto:psoler at vhebron.net>  /  34660psp at comb.cat<mailto:34660psp at comb.cat>
Web: www.upiip.com<http://www.upiip.com/>
ResearchGate: http://www.researchgate.net/profile/Pere_Soler-Palacin
LinkedIn: http://es.linkedin.com/pub/pere-soler-palac%C3%ADn/73/918/b16

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________________________________
De: "CIS-PIDD" <cis-pidd at lists.clinimmsoc.org<mailto:cis-pidd at lists.clinimmsoc.org>>
Per: "CIS-PIDD" <cis-pidd at lyris.dundee.net<mailto:cis-pidd at lyris.dundee.net>>
Enviats: Dimecres, 1 de Juny 2016 14:06:18
Assumpte: [cis-pidd] recurrent pneumonia

Colleagues:

I would like suggestions on a 46 yo female anesthesiologist with recurrent pneumonia. She has had five episodes of pneumonia over the last 15 years. Two requiring hospitalization and one ICU admission. Her most recent pneumonia admission occurred despite beginning levofloxacin within three hours of the onset of symptoms. Her infection history includes recurrent sinusitis when young that has become a much less frequent problem, a large cellulitis after a stingray envenomation and MRSA sinusitis following surgery. She is a non-smoker. Her most recent pneumonia occurred while on vacation and was not hospital acquired.

IgG 1070   IgA 132   IgM 125

Responded to 17/23 pneumococcal serotypes, adequate response to DT and H. flu. CH50 and AH50 normal.

Mannose binding lectin undetectable.

Suggestions for additional studies?

Given the fact that she averages less than on infection per year, I have been unenthusiastic about antibiotic prophylaxis. Any management recommendations?

Thank you,

Richard Wasserman

Dallas

--
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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