[CIS PIDD] [cis-pidd] CVID with chronic GI campylobacter

[CIS-PIDD]

I just took over care for a 66 y/o male with CVID, inclusion body myositis
(previously thought to be polymositis but 2nd opinion leaning inclusion),
pancytopenia (WBC 3-4,000, Hgb~10, platelets 40-70 and ALC 300-800 over
last few years).  On diagnosis in 2012 his labs were IgG<40, IgA<5, and
IgM<5, last IgG trough was 798.  No genetics have been done.

His biggest active issue is chronic diarrhea from chronic GI
campylobacter.  He has had treatment with amoxicillin, levofloxacin,
ciprofloxacin, azithromycin, and doxycycline.  Based on stool PCR testing,
none of these have cleared the infection.  Multiple endoscopies hae shown
active colitis, granulation tissue, crypt apoptosis, always thought to be
secondary to campylobacter

As recent as last year his IgG had been closer to 1200 and he had no
sinopulmonary infections (he has had 2 pneumonias this year with lower
levels, we will be working on getting IgG trough back up), but did have
continued diarrhea and campylobacter.

Most recent stool culture and multiplex PCR in February was positive for
campylobacter.  He has had significant weight loss and loss of IgG from
this diarrhea.  ID is planning to repeat culture with sensitivities next
week.  But I wanted to reach out to see if anyone else has experience with
chronic campylobacter in patients with CVID.  Any ideas for next step in
treatment?

Thank you for your help
Nick
-- 



Nicholas Hartog, MD

Allergy and Clinical Immunology

Assistant Professor – Michigan State University College of Human Medicine

Nicholas.hartog at spectrumhealth.org

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