[CIS PIDD] [cis-pidd] Selective Antibody Deficiency

[CIS-PIDD]

In  2012, the Clinical Immunology Committee of the AAAAI issued a working group report published in JACI reclassifying selective antibody deficiency into 4 groups, including a mild category, defined as a lack of response to 2 or more of the serotypes in the Pneumovax vaccine.  They also stated that treatment with replacement Ig might be warranted.

The Primary Immunodeficiency Committee of the AAAAI has just published a work group report reiterating the same recommendation.  That report is currently available online and will be published in JACI in March 2017.  With both groups in agreement regarding the potential use of Ig in patients with this diagnosis, is there now a consensus that treatment may be appropriate in some patients with the mild phenotype?

I recognize that until now, many disagreed with that original suggestion.  I primarily treat patients with chronic rhinosinusitis which is resistant to all treatments including multiple surgeries, culture directed antibiotics, omalizumab, etc.  I have had several patients with SAD mild phenotype who received a trial of Ig and have responded well to therapy.  While there may be a limited number of patients who require this treatment, it can be very beneficial.

I would appreciate the groups thoughts on this since many insurance companies still refuse to authorize treatment under the above circumstances.


Sincerely,

Wellington S. Tichenor, MD, FACP, FAAAI
642 Park Avenue
New York, New York 10065
212 517-6611
wtichenor at sinuses.com<https://register.concentric.com/home/apps/mail/mbox_compose.cgi?pTo=wtichenor@sinuses.com>




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