[CIS PIDD] [cis-pidd] CVID, bronchiectasis, atypical mycobacteria, hemoptysis

[CIS-PIDD]

Hello Colleagues,

I am seeing more adults with PIDD in practice now. Coming from the pediatric side, it is interesting (and scary at times) to see some of the complications-- that I’ve not had to routinely manage yet-- of CVID later in life.

Yesterday I saw two patients one male in their 50s and a 63yo female with CVID, bronchiectasis, atypical mycobacteria and recurrent hemoptysis. Both are followed by pulmonologists locally and one has been to National Jewish for evaluation. It seems there are differing opinions on the treatment of atypical mycobacteria in these patients.

My questions are:
1/ are there any guidelines you use for these patients on acute management of hemoptysis episodes?
2/ how aggressively do you follow cultures for atypical mycobacteria and treat/retreat/stay on treatment?
3/ for patients with CVID and bronchiectasis whose pulmonologists feel they are at “end stage” do you initiate a lung transplant evaluation? if so where? (we are in South FL)

Thanks!
Elena

Allergy Associates of the Palm Beaches
840 US Highway 1, Suite 235
North Palm Beach, FL 33408

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