igA def

[aspiringmd1015]

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with igA deficiency, what do we have to know in regards to giving blood products? as anti-igA(igG) forms, i have something written like if whole blood pr blood products wer transfused, dont give gamma globulins bc it will worsen the disease. Confused about this, can anyone just clear the concept of what we have to know about giving blood products besides blood causing anaphlyaxis.

 

[dfib slim]

When you have IgA deficiency you develop anti IgA antibodies and can go into anaphylaxis when given blood products that contain IgA.

Also, one association you might see is with celiac disease. May not be able to trust that negative anti IgA transglutaminase so get the biopsy.

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[aspiringmd1015]

When you have IgA deficiency you develop anti IgA antibodies and can go into anaphylaxis when given blood products that contain IgA.

Also, one association you might see is with celiac disease. May not be able to trust that negative anti IgA transglutaminase so get the biopsy.

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right, cant we just check igG before we go for biopsy?
ALso which vaccines besides MMR can we give to an HIV patient? what about in pregnancy? can we give any live attenuated vaccines in preg/or immunocompromised states?

 

[dfib slim]

right, cant we just check igG before we go for biopsy?
ALso which vaccines besides MMR can we give to an HIV patient? what about in pregnancy? can we give any live attenuated vaccines in preg/or immunocompromised states?

You're starting to get out of Step 1 territory with these now. Celiac disease testing can be based on pretest probability. With low probability, negative transglutaminase IgA, and low total IgA, you can check the deamidated gliadin peptide IgG. Not really step 1 material.

Live vaccines in HIV depend on the CD4 count. If >200 you can give MMR and varicella. If <200 you don't. Vaccines with immunodeficiencies get more complicated depending on which variety but I'd stick with no live vaccines if there is a T cell deficiency. No live in pregnancy either.

 

[aspiringmd1015]

You're starting to get out of Step 1 territory with these now. Celiac disease testing can be based on pretest probability. With low probability, negative transglutaminase IgA, and low total IgA, you can check the deamidated gliadin peptide IgG. Not really step 1 material.

Live vaccines in HIV depend on the CD4 count. If >200 you can give MMR and varicella. If <200 you don't. Vaccines with immunodeficiencies get more complicated depending on which variety but I'd stick with no live vaccines if there is a T cell deficiency. No live in pregnancy either.

Okay sweet, one more question, what difference do we have to know between pyogenes toxic shock, aureus toxic shock, and the rash in scarlet fever?


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[dfib slim]

Maybe something like being able to recognize it through the history and knowing something about the mechanism.

When you taking step? You been on here for a few years now.


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