[CIS PIDD] [cis-pidd] CVID/IVIg/heparin in patient with h/o PE

[CIS-PIDD]

Agreed, Klaus, and thank you!

CTLA4, etc. investigation underway.


Katherine Gundling, MD, FACP
Clinical Professor
Allergy and Immunology
UC San Francisco
400 Parnassus Ave. Box 0359
San Francisco, CA 94143
Clinic: 415-353-2725
Pager: 415-443-7682
________________________________
From: cis-pidd at lyris.dundee.net <cis-pidd at lyris.dundee.net> on behalf of CIS-PIDD <cis-pidd at lists.clinimmsoc.org>
Sent: Saturday, September 16, 2017 2:11:02 AM
To: CIS-PIDD
Subject: Re: [cis-pidd] CVID/IVIg/heparin in patient with h/o PE

Was the patient investigated for an underlying monogenic disorder like CTLA4 deficiency or alike? There are too many secondary complications to have ED, crohn and CVID. I agree if patient is happy with it SC may be a good option
Klaus

Sent from my iPhone

On 15 Sep 2017, at 23:00, CIS-PIDD <cis-pidd at lists.clinimmsoc.org<mailto:cis-pidd at lists.clinimmsoc.org>> wrote:


Dear colleagues:

I have a newly diagnosed, 37 year old CVID patient who needs IVIg before (and after) receiving rituximab for multiple sclerosis. She was diagnosed with PE in 2009 associated with Crohn disease (otherwise no clear etiology), and treated without complication or recurrent problems when anticoagulation was stopped.


Do any of you routinely give prophylactic subQ heparin (or other anticoagulation practice) before IVIg in patients with a history of PE?

Would you do so in this patient? She is ambulatory and has relatively good functional status in spite of the MS.


Your thoughts would be greatly appreciated.


Katherine


Katherine Gundling, MD, FACP
Clinical Professor
Allergy and Immunology
UC San Francisco
400 Parnassus Ave. Box 0359
San Francisco, CA 94143
Clinic: 415-353-2725
Pager: 415-443-7682

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