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Hi Ursula,

He has been tested for both, he's seen mainly

by Dr. Larry , but he's also been seen by Dr.

Buckley and she's had input in his treatment and

diagnosis.

--- Ursula Holleman <uahollem1@...> wrote:

> - who treats Jack at Duke? Has he ever been

> tested for Hyper IgM or NEMO?

>

> Ursula - mom to (15) and Macey (12, CVID)

> http://www.primaryimmune.org

> http://www.jmfworld.org

> http://caringbridge.org/ga/macey/

>

>

> [Non-text portions of this message have been

> removed]

>

>

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The reason I ask is because those are the diagnosis' that seem to be prone to

the enterovirus infections that attack the brain. The NIH work has been with

boys affected with these two diagnosed PID's. I've heard of Dr. and

Dr. Buckley has also been a wonderful resource in Macey's early diagnosis days.

I'm curious what deficiency was found that lead to the BMT possibility.

Generally most PID's of a b-cell nature are not treated with BMT or cord blood

transplant because of the risk of chemo being so great. But if a patient has a

combined immune deficiency (CID) which involves a t-cell deficiency or

dysfunction they are more of a candidate. Also we've had some CVID patients

with severe autoimmune disease who have had BMT's. Some are fortunate enough to

resolve their autoimmune problem as well as their b-cell problem but some are

still lacking b-cell function and are able to resolve the autoimmune component.

Transplant for CVID patients is still a case by case thing and there is no

established protocol or criteria as there is for SCID.

Ursula - mom to (15) and Macey (12, CVID)

http://www.primaryimmune.org

http://www.jmfworld.org

http://caringbridge.org/ga/macey/

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I think that the enterovirus infection led them to

test for Nemo, but he had been tested for the other a

while back. They've actually done repeat testing at

St. Judes to duplicate all of Duke's tests and the

results were still the same. They were going to do

the BMT before they found out about the enterovirus

infection in the brain cells. All tests for

enterovirus from Jack's spinal fluid came back

negative until Jack's brain biopsy. Usually when the

virus is in the brain, the spinal fluid will reflect

that, Jack's viral cultures in his spinal fluid were

always negative, although his spinal fluid is

abnormal, it's like that of someone with viral

miningitis. I should say that he did have a stool

sample and nasal wash very early on that came back

positive for enterovirus, which is why they continued

to follow that lead. Before the biopsy the doctor's

were beginning to think he had an autoimmune component

that had not been identified yet that was causing his

central nervous system decline since they could not

identify anything else. The thought was that if it

was autoimmune the BMT was an option.

--- Ursula Holleman <uahollem1@...> wrote:

> The reason I ask is because those are the diagnosis'

> that seem to be prone to the enterovirus infections

> that attack the brain. The NIH work has been with

> boys affected with these two diagnosed PID's. I've

> heard of Dr. and Dr. Buckley has also been

> a wonderful resource in Macey's early diagnosis

> days. I'm curious what deficiency was found that

> lead to the BMT possibility. Generally most PID's

> of a b-cell nature are not treated with BMT or cord

> blood transplant because of the risk of chemo being

> so great. But if a patient has a combined immune

> deficiency (CID) which involves a t-cell deficiency

> or dysfunction they are more of a candidate. Also

> we've had some CVID patients with severe autoimmune

> disease who have had BMT's. Some are fortunate

> enough to resolve their autoimmune problem as well

> as their b-cell problem but some are still lacking

> b-cell function and are able to resolve the

> autoimmune component. Transplant for CVID patients

> is still a case by case thing and there is no

> established protocol or criteria as there is for

> SCID.

>

> Ursula - mom to (15) and Macey (12, CVID)

> http://www.primaryimmune.org

> http://www.jmfworld.org

> http://caringbridge.org/ga/macey/

>

>

> [Non-text portions of this message have been

> removed]

>

>

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that makes sense. they would hopefully have successfully resolved the CNS

symptoms as well as his PID. I wish things had turned out better for him. Did

you see Dr. Conley at St. Judes? I've heard her speak twice and enjoy it more

each time. She's very passionate about what she does.

Ursula - mom to (15) and Macey (12, CVID)

http://www.primaryimmune.org

http://www.jmfworld.org

http://caringbridge.org/ga/macey/

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