[CIS PIDD] [cis-pidd] Gardasil and Antibody deficiency

[CIS-PIDD]

Good Morning, Mike.

The best surrogate measure of protection against genital HPV is serum IgG antibody titer.  In contrast to respiratory and GI mucus membranes, the predominant immunoglobulin isotype in vaginal secretions is IgG, transported across vaginal epithelium via Fcn.

Because of this I have elected not to give Gardasil to patients with agammaglobulinemia.  Alternatively, if the patient makes some IgG (some CVIDs, specific antibody deficiencies), I do give Gardasil.

I would be interested in others' approach.

Joe Church
Children's Hospital Los Angeles

PS.  Does anyone knows a lab that can measure HPV antibody levels?

From: CIS-PIDD [mailto:cis-pidd at lists.clinimmsoc.org]
Sent: Wednesday, October 05, 2016 6:58 AM
To: CIS-PIDD
Subject: [cis-pidd] Gardasil and Antibody deficiency

Dear colleagues,

The question of whether to give gardasil to our young adolescents with CVID and other primary antibody disorders has come up a few times in our clinic and I'm curious about the group consensus.   We have been of the opinion that since it is inactivated, and we have no data regarding whether IVIG provides any protection against HPV,  it is unlikely to cause harm, and may potentially induce a cellular response that could be beneficial.

Thanks in advance!
Mike



Michael D. Keller, MD

Assistant Professor, Division of Allergy / Immunology

Center for Cancer and Immunology Research

Jeffrey Modell Diagnostic and Research Center for

Primary Immunodeficiency Disorders

Children's National Health System

111 Michigan Ave NW, M7745A

Washington, DC 20010

Clinic: 202.476.3016

Office: 202.476.5843

Fax: 202.476.2280

www.ChildrensNational.org<http://www.ChildrensNational.org>



________________________________
Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.

---

You are currently subscribed to cis-pidd as: jchurch at chla.usc.edu<mailto:jchurch at chla.usc.edu>.

To unsubscribe click here: http://cts.dundee.net/u?id=96396658.df9245d5219d19fc82ac9f3bbf52c836&n=T&l=cis-pidd&o=3881016

(It may be necessary to cut and paste the above URL if the line is broken)

or send a blank email to leave-3881016-96396658.df9245d5219d19fc82ac9f3bbf52c836 at lyris.dundee.net<mailto:leave-3881016-96396658.df9245d5219d19fc82ac9f3bbf52c836 at lyris.dundee.net>


---------------------------------------------------------------------
CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, 
is for the sole use of the intended recipient(s) and may contain confidential
or legally privileged information. Any unauthorized review, use, disclosure
or distribution is prohibited. If you are not the intended recipient, please
contact the sender by reply e-mail and destroy all copies of this original message.  

---------------------------------------------------------------------


---
You are currently subscribed to cis-pidd as: pagid at list.clinimmsoc.org.
To unsubscribe click here: http://cts.dundee.net/u?id=96396833.5a9591ccd1e327fe6bc4d1543298c482&n=T&l=cis-pidd&o=3881046
or send a blank email to leave-3881046-96396833.5a9591ccd1e327fe6bc4d1543298c482 at lyris.dundee.net
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <https://pairlist7.pair.net/pipermail/pagid/attachments/20161005/560b9ac3/attachment-0001.html>