[CIS PIDD] [cis-pidd] Severe recurrent sinusitis in a CVID pregnant women

[CIS-PIDD]

You could certainly increase her dose but, if she has had prolonged
treatment with a beta-lactam, I would consider trimethoprim/sulfa (until 36
weeks) or clarithromycin. A nasal endoscopy may be helpful.
Richard Wasserman

On Thu, Dec 22, 2016 at 10:35 AM, CIS-PIDD <cis-pidd at lists.clinimmsoc.org>
wrote:

> Thank you very much for your answer.
>
>
> Surgery once, five years ago. IgG levels right before IVIG infusion last
>  month. Pregnant, no CAT scan possible right now. She does reasonably well
> on rifampin / amoxicillin / clavulanate + nasal steroids + nasal washings.
> But now she is pregnant and I can not find an appropriate treatment for
> her. Would anybody increase the IVIG dose, would it be useful to use
> any nasal
>
> medication (beyond mupirocin already done). What about nasal IVIG, any
> thoughts? Experience?
>
>
> Alejandro Malbran
>
>
> ------------------------------
> *From:* CIS-PIDD <cis-pidd at lists.clinimmsoc.org>
> *Sent:* Thursday, December 22, 2016 12:34 PM
> *To:* CIS-PIDD
> *Subject:* Re: [cis-pidd] Severe recurrent sinusitis in a CVID pregnant
> women
>
> Has she ever had sinus surgery? When was her last sinus CT and what did it
> show? When was she last completely well? What was her IgG level at that
> time?
> Richard Wasserman
> Dallas
>
> On Thu, Dec 22, 2016 at 9:15 AM, CIS-PIDD <cis-pidd at lists.clinimmsoc.org>
> wrote:
>
>> Dear Sir,
>>
>>
>> I would greatly appreciate your input to treat a young lady, 16 weeks
>> pregnant, with severe sinusitis. She does nasal washing and takes
>> amoxicillin. Her IgG is 975, no IgA, IgM nor IgE. She is replaced every 4
>> weeks with 30 gr. Any suggestion is welcome.
>>
>>
>> Best regards,
>>
>>
>> Alejandro Malbran
>>
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>
>
>
> --
> 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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-- 
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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