Document Detail


Subcutaneous immunoglobulin therapy in an 11-year-old patient with common variable immunodeficiency and von Willebrand disease.
MedLine Citation:
PMID:  17941286     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Subcutaneous immunoglobulin (SCIG) is an option for replacement therapy in patients with humoral immune deficiencies. OBJECTIVE: To describe a patient with common variable immunodeficiency (CVID) and von Willebrand disease who tolerated immunoglobulin replacement via the subcutaneous route. METHODS: An 11-year-old boy receiving monthly intravenous immunoglobulin (IVIG) since 5 years of age presented to an academic medical center after moving to the area. The patient also had a history of von Willebrand disease. He had started receiving IVIG because of recurrent infections and an absent IgG subclass 3. Further immunologic assessment revealed a normal B-cell count, decreased IgM level, and an abnormal response to bacteriophage phiX174. Given these findings and the lack of another cause, the patient was diagnosed as having CVID. Because of difficult intravenous access, a port was placed for IVIG administration in 1999. The initial port was removed because of infectious complications, and a second port was found to be distally displaced in the right atrium, requiring removal. RESULTS: Continued difficulties with intravenous access and the potential complications with maintaining a long-term indwelling catheter prompted consideration of alternative methods for immunoglobulin administration. After removal of the port, the patient was prescribed weekly SCIG infusions. He tolerated the infusions well without bleeding complications related to the von Willebrand disease and was able to transition to home infusions. CONCLUSIONS: SCIG was well tolerated by a pediatric patient with CVID and von Willebrand disease without any significant bleeding complications.
Authors:
Rajiv Arora; Thomas C Newton; Michael R Nelson
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology     Volume:  99     ISSN:  1081-1206     ISO Abbreviation:  Ann. Allergy Asthma Immunol.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-18     Completed Date:  2007-12-06     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  9503580     Medline TA:  Ann Allergy Asthma Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  367-70     Citation Subset:  IM    
Affiliation:
Department of Allergy/Immunology, Walter Reed Army Medical Center, Washington, DC 20307, USA. rajiv.arora@us.army.mil
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MeSH Terms
Descriptor/Qualifier:
Child
Common Variable Immunodeficiency / complications,  diagnosis,  therapy*
Humans
Immunization, Passive / methods*
Immunoglobulins / administration & dosage*,  therapeutic use
Infusions, Parenteral
Male
Treatment Outcome
von Willebrand Diseases / complications*
Chemical
Reg. No./Substance:
0/Immunoglobulins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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