[CIS PIDD] [cis-pidd] Rubella in granulomas

[CIS-PIDD]

Greetings,

I am caring for an 18 y/o male pt. with ataxia-telangiectasia who has exuberant cutaneous and hepatic granulomas which (both) stain positive for rubella capsid. I am looking for possible therapies to consider on the assumption that the presence of the virus has some role to play in pathogenesis. I am not aware that this has been "proven" in any case, which is why I call it an assumption. Things to consider:


1.       High dose IgG. While probably not effective by itself and there is some evidence to suggest lack of efficacy for established infection, it could be an adjunct to something else.

2.       Something else:

a.       Interferon - type 1, I have heard second-hand anecdotal report regarding a lack of efficacy but would be interested in hearing from someone who has tried it.

b.      Interferon gamma, not sure if anyone has tried it

c.       Ribavirin, I have heard anecdotally that it is being tried but I don't know about results

d.      Nitizoxanide, same

I would appreciate everyone's thoughts, thank you.

Tony B.

Francisco A. Bonilla, M.D., Ph.D.
Director, Clinical Immunology Program, Boston Children's Hospital
Associate Professor of Pediatrics, Harvard Medical School


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