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Suggest Treatment For Deficiency Of Humoral Immunity
Question: Yes, Is your name Dr. Rynee? - as I see listed above?
I am in a difficult position, I'm 52 years old,
I forgot to mention treatments I have done;
Right Hand; Mayo Clinic - XXXXXXX Cooney, M.D.; I was told that it would be impossible to repair the right hand. There are 3 ganglion cysts on the hand also:
two directly underneath the carpal bossing that has formed over the broken bones, and one on the right side of the wrist. I tried cortisone injections into the right wrist, but the pain increased. The only thing that helps my hand is to bind it, and try to use my left hand as much as possible.
Migraines - went to Saper Clinic through University of Michigan-Ann Arbor Hospital
many of the headaches are hormonally mediated. Sumatriptan succinate is thus far the only thing that helps with the headaches.
What I am concerned about mostly is the immunodeficiency/endocrine deficiency
issue. The BHRT is non-negotiable - without it, I have more pain and cognitive problems. I tried going without it for 18 months. At best, I functioned 2 hours a day.
My ultimate question is 'Where in the world can I go for first class integrative medical care for such a complicated case? My father was a Hematologist/Internist that worked for NATO, so I am used to a more International approach to medicine.
Also, I forgot to mention - like my cortisol levels, my blood pressure fluctuates very rapidly...and to the amazement of some physicians, I have raised it and lowered it extensively via what I think about. I am well aware of how important our cognition is to our health condition. However, what I can't control is the high frequency of infections...I'm tired of it...
I am in a difficult position, I'm 52 years old,
I forgot to mention treatments I have done;
Right Hand; Mayo Clinic - XXXXXXX Cooney, M.D.; I was told that it would be impossible to repair the right hand. There are 3 ganglion cysts on the hand also:
two directly underneath the carpal bossing that has formed over the broken bones, and one on the right side of the wrist. I tried cortisone injections into the right wrist, but the pain increased. The only thing that helps my hand is to bind it, and try to use my left hand as much as possible.
Migraines - went to Saper Clinic through University of Michigan-Ann Arbor Hospital
many of the headaches are hormonally mediated. Sumatriptan succinate is thus far the only thing that helps with the headaches.
What I am concerned about mostly is the immunodeficiency/endocrine deficiency
issue. The BHRT is non-negotiable - without it, I have more pain and cognitive problems. I tried going without it for 18 months. At best, I functioned 2 hours a day.
My ultimate question is 'Where in the world can I go for first class integrative medical care for such a complicated case? My father was a Hematologist/Internist that worked for NATO, so I am used to a more International approach to medicine.
Also, I forgot to mention - like my cortisol levels, my blood pressure fluctuates very rapidly...and to the amazement of some physicians, I have raised it and lowered it extensively via what I think about. I am well aware of how important our cognition is to our health condition. However, what I can't control is the high frequency of infections...I'm tired of it...
Brief Answer:
Deficiency of humoral immunity and chronic adrenal insufficiency
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
You seem to have deficiency of humoral immunity(B cells which produces immunoglobulins/antibodoes) more precisely Common Variable Immunodeficiency (CVID) ,an ill-defined condition characterized by low serum levels of one or more Ig isotypes.
Antibody deficiencies result in recurrent bacterial infections, frequently with organisms such as S. pneumoniae and Haemophilus influenzae.
Patient can be treated by Immunoglobulin Replacement.
Injection of plasma-derived polyclonal IgG containing a myriad of high-affinity antibodies can provide protection against disease-causing microorganisms in patients with defective IgG antibody production.
Immunoglobulin replacement can be performed by IV or subcutaneous routes. In the former case, injections have to be repeated every 3–4 weeks, with a residual target level of 800 mg/mL in patients who had very low IgG levels prior to therapy.
Subcutaneous injections are typically performed once a week, although the frequency can be adjusted on a case-by-case basis.
You need to consult a clinical immunologist for that.
On the contrary hypoadrenalism/adrenocortical insufficiency is easier to treat.
Glucocorticoid replacement for the treatment of chronic adrenal insufficiency is usually achieved by the oral administration of 15–25 mg hydrocortisone in two to three divided doses.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Deficiency of humoral immunity and chronic adrenal insufficiency
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
You seem to have deficiency of humoral immunity(B cells which produces immunoglobulins/antibodoes) more precisely Common Variable Immunodeficiency (CVID) ,an ill-defined condition characterized by low serum levels of one or more Ig isotypes.
Antibody deficiencies result in recurrent bacterial infections, frequently with organisms such as S. pneumoniae and Haemophilus influenzae.
Patient can be treated by Immunoglobulin Replacement.
Injection of plasma-derived polyclonal IgG containing a myriad of high-affinity antibodies can provide protection against disease-causing microorganisms in patients with defective IgG antibody production.
Immunoglobulin replacement can be performed by IV or subcutaneous routes. In the former case, injections have to be repeated every 3–4 weeks, with a residual target level of 800 mg/mL in patients who had very low IgG levels prior to therapy.
Subcutaneous injections are typically performed once a week, although the frequency can be adjusted on a case-by-case basis.
You need to consult a clinical immunologist for that.
On the contrary hypoadrenalism/adrenocortical insufficiency is easier to treat.
Glucocorticoid replacement for the treatment of chronic adrenal insufficiency is usually achieved by the oral administration of 15–25 mg hydrocortisone in two to three divided doses.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
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