Sinus Infection - dose related?

[Pilgrim]

H is battling a terrible sinus infection. She had a dose increase of Humira to 80mg weekly in the past month. I wonder if they are related. Any experience?

Any advice for this issue? I am using a saline spray for her but I am not seeing much relief.

This is not directly a Crohn's thing but our kiddos have extra trouble due to suppressed immune systems.

 

[my little penguin]

Hmmm
Ds was on humira every 5 days for a year or more
Plus mtx abd another biologic
Fall in person school he did get a lot of strep throat /ear infections from age 7 on (pre biologics )
So his were not necessarily related
Removal of tonsils /adenoids while on humira (age 9) didn’t really help much either
Same as my non ibd kiddo
Both out grew the sinus /strep /ear infection merry go round by teenagers
But it took forever

 

[pdx]

My daughter has had her share of minor infections while on biologics + mtx. About twice a year, a regular cold turns into a sinus infection, ear infection, or bronchitis. Usually a short course of antibiotics takes care of it. She rarely has a fever with the infection, due to her suppressed immune system. One of the only silver linings of the pandemic has been the complete lack of infections since both my kids are doing school from home. Hope H feels better soon.

 

[Maya142]

80 mg weekly is 4x the normal dose of Humira. My kiddo has not been on that (actually, your daughter is the first kid I've heard of to be on 40 mg every 3.5 days), but she has been on 8x the normal dose of Remicade and 4x the normal dose of Simponi. Both times, she was also on an immunomodulator (MTX or Imuran or something similar). She actually did not have more infections than prior to being on biologics or while on lower doses of biologics but she took longer to recover from them when she did get them.

While on those meds, her pattern was one cold a year which turned into a sinus infection typically. She generally needed abx and those sometimes caused C.Diff - that was actually the bigger problem for her.

There was nothing special that she did to avoid infections - just a flu shot every winter. And if she had a friend or family member with a cold, she tried to keep her distance.

I hope H feels better soon!

 

[Pilgrim]

80 mg weekly is 4x the normal dose of Humira. My kiddo has not been on that (actually, your daughter is the first kid I've heard of to be on 40 mg every 3.5 days), but she has been on 8x the normal dose of Remicade and 4x the normal dose of Simponi. Both times, she was also on an immunomodulator (MTX or Imuran or something similar). She actually did not have more infections than prior to being on biologics or while on lower doses of biologics but she took longer to recover from them when she did get them.

While on those meds, her pattern was one cold a year which turned into a sinus infection typically. She generally needed abx and those sometimes caused C.Diff - that was actually the bigger problem for her.

There was nothing special that she did to avoid infections - just a flu shot every winter. And if she had a friend or family member with a cold, she tried to keep her distance.

I hope H feels better soon!

Thank you! Nobody else is sick here but H. I'm not sure where she picked it up. They are masked all day at school (inside and outside) and we've been in provincial stay at home order since Christmas. In the past few years she does tend to be the first one sick and the last to get well. It might make the rounds yet.

I actually asked if I could break her dose down to one shot every 3.5 days...but no go. It has to be both 40mg injections at one time. She has been handling it like a champ.

I'm trying to avoid abx....it tends to complicate things but we may need them.

 

[crohnsinct]

Funny you should ask and mention the mask thing. When I got Covid it felt like a sinus infection at first and that is what I called the doc about. She actually said that while all the mask wearing has dramatically cut down on the other usual seasonal yuck they were seeing an uptick in sinus infections and their theory was perhaps people were getting it from their masks....not changing them frequently enough, kids drippy noses dripping into them etc. This is not to say don't wear masks!!!!! But perhaps she caught it more from that than something else?

Also, are you sure it is a sinus infection? Has she been tested for Covid? Both O and I thought we had sinus infections when we first started experiencing symptoms.

If it is a sinus infection, we have had excellent luck with Oil of Wild Oregano. Two drops under the tongue anti knocks a lot of icky things out.

 

[Pilgrim]

I should give the oil of oregano a try. We have family members who would rather we drop Humira and treat everything with herbs....so I get this knee jerk reaction to herbal speak but I am sure it helps some things. I will look for it for the sinus infection.

Oh man...no, I didn't get her tested for covid. My research showed that sinus infection symptoms and covid didn't line up so I put it out of mind. Both of you had it as an initial symptom? How long between the infection and other symptoms? She has no other symptoms except exhaustion slightly beyond normal.

The masks are on all day at school. I send her with 4 because it is bitterly cold up here so when they wear them outside they get soggy from condensation and that can't be healthy. The cold also makes the indoor air really dry. We just replaced our humidifier to a better and larger model but it is still struggling to keep up with the dry air. That is also bad for sinuses -but her infection started with a very runny nose initially then got worse. That seems viral or bacterial.

 

[crohnsinct]

O and I progressed to full on Covid symptoms in about 4-5 days. But everyone is different. Some people don’t exhibit any symptoms, some just feel like they have a cold. O and my husband had respiratory symptoms and I didn’t. I had high fevers and they didn’t. You just never know and I would just get her swabbed to definitively rule it out. Especially since your home is a small village and you don’t want the virus running through.

I will say we were both pretty shocked when our tests turned up positive and thought we were going to be lucky with a mild version but then things got pretty bad.

I hear ya on the unsolicited advice on healing Crohns. I have gotten it from many.It’s her diet, stress, my chiropractor can cure Crohns, she needs vitamin d etc.

BUT while I am not saying oil of wild oregano helps Crohn’s I will say that my family swears by it. My older daughter brought it to college and the minute she felt a bit of anything she would take it and not get sick or at least not get as sick as her room mates. She got to the point she took it every day on a preventative basis. My friend suffers with sinus issues and she also uses it and swears by it. Iur GI approved its use with Remicade but we haven’t checked about Humira so you might just want to mention it.

 

[maher]

H is battling a terrible sinus infection. She had a dose increase of Humira to 80mg weekly in the past month. I wonder if they are related. Any experience?

Any advice for this issue? I am using a saline spray for her but I am not seeing much relief.

This is not directly a Crohn's thing but our kiddos have extra trouble due to suppressed immune systems.

Hi, speaking from experience I started to suffer from serious sinusitis while on infliximab. It can be a side effect of the treatment (Biologics) It may mean that H may need to switch treatment if it gets any worse. Once I was switched to humira it started to get better.
Please do not ignore I now look like someone who has wegners, full nasal bridge collapse. The damage had been done as my GI consultant didn't believe that it was related. (Research biologics and chronic sinusitis)
Neilmed sinus rinse is the only thing that gave me any relief, forget the sailine spray, it is too harsh and speak to your doctor and keep monitoring.

I wish you all the best, hope this helps x

 

[Maya142]

I actually asked if I could break her dose down to one shot every 3.5 days...but no go. It has to be both 40mg injections at one time. She has been handling it like a champ.

She is a champ!! Checking for COVID is a good idea - it seems like everyone has really different symptoms. I hope it's not that and is a sinus infection.