High CD3-/CD16+/CD56 NK cells.

[SaraEngland]

I received some test results from the lab today:

These tests are considered out of range:

MCHC 31.6 (33-36)
Neutrophiles (47.7 (55-70)
Lymphocytes 45 (25-40)

T Lymphocytes:

CD3+/HLADR+ T-lymphocytes (relative) 0.9 %
CD3+/HLADR+ T-lymphocytes (absolute) 27.2 (30-200)

NK:

NK CD3-/CD16+/CD56+ (relative) 16.5 (3-13)
NK CD3-/CD16+/CD56+ (absolute) 502 (80-600)


Lab said it could be due to an active infection.


I thought low NK cells was often seen in ME, not high? Does anyone have comments? Could I have some kind of an active infection?

 

[heapsreal]

Its function that is commonly low so its possible to have high nk count but they just dont work properly ? ?

Otherwise you tests look similar to mine with low neutrophils and high lymphocytes , but these tests vary amongst cfsers. Interesting to get the same tests every 3 to 6 months and look at the pattern . Maybe try to get an nk function test which might be hard to get.

 

[SaraEngland]

But what does the high number mean? That the NK cells doesn't work properly? Or that they work their ass of??

 

[heapsreal]

But what does the high number mean? That the NK cells doesn't work properly? Or that they work their ass of??

At a guess probably indicates your currently fighting an active infection .

 

[SaraEngland]

At a guess probably indicates your currently fighting an active infection .

I've had ME for 6 years and I feel like like I always do. Nothing new. I was bit by a tic 15 years ago, but didn't have any symptoms afterwards.. I have just done regular lyme tests provided by the public health care system in Sweden.

What would you do? Try a few weeks on oral doxycycline?

 

[heapsreal]

I've had ME for 6 years and I feel like like I always do. Nothing new. I was bit by a tic 15 years ago, but didn't have any symptoms afterwards.. I have just done regular lyme tests provided by the public health care system in Sweden.

have you been tested for common viruses in cfsme?
Google cfs road map which has alot of info about testing

What would you do? Try a few weeks on oral doxycycline?

 

[SaraEngland]

Yeh.. Been tested for every virus that is possible in Sweden. 4 pages with blood tests!

 

[heapsreal]

Yeh.. Been tested for every virus that is possible in Sweden. 4 pages with blood tests!

Infections reactivating is something they cant really tell . Seeing your immune system is dysfunctional means its a possibility but we cant tell which infection. At your stage many do a treatment trial of antivirals and antibiotics which generally are taken long term.

sometimes you can see changes in immune tests. My lymphocyte testing whoch was originally high to come down although still above normal. I did stop antivirals and these figures increased and then dropped again when i restarted treatment . So it indicated the antivirals were helping.

I can't say it will help you but its an option to try if you think infections are related??

good luck

 

[Jonathan Edwards]

But what does the high number mean? That the NK cells doesn't work properly? Or that they work their ass of??

The problem with these counts is that they can mean almost anything or nothing. A high count for a cell type may mean more are being sent into the circulation or fewer are going out into tissues - busy or lazy. As an immunologist I would not normally take note of numbers like that. Remember that about one in ten results will be a bit out of range just on a normal statistical basis.

 

[SaraEngland]

@Jonathan Edwards, thank you for your answer.

 

[sarah darwins]

The problem with these counts is that they can mean almost anything or nothing. A high count for a cell type may mean more are being sent into the circulation or fewer are going out into tissues - busy or lazy. As an immunologist I would not normally take note of numbers like that.

Does this mean the tests are not worth doing? Or that additional data is needed in order to learn something from them? If the latter, what sort of data?

 

[Jonathan Edwards]

Does this mean the tests are not worth doing? Or that additional data is needed in order to learn something from them? If the latter, what sort of data?

Whether or not the tests are worth doing depends on the clinical problem and what is being looked for. I doubt the lymphocyte subset tests are worth doing just in the context of ME symptoms. Values slightly out of the reference range do not often mean much. Values far out of range might well do. It is not really possible to begin explaining what interpretation depends on other than to say it mainly the clinical history and examination findings - which could be anything.

 

[sarah darwins]

Whether or not the tests are worth doing depends on the clinical problem and what is being looked for. I doubt the lymphocyte subset tests are worth doing just in the context of ME symptoms. Values slightly out of the reference range do not often mean much. Values far out of range might well do. It is not really possible to begin explaining what interpretation depends on other than to say it mainly the clinical history and examination findings - which could be anything.

Thanks, Jonathan. I asked because I just paid the bill for similar tests! (among many others, I should add). I'm going to assume that my doctor (Kenny de Meirleir) has good reasons for wanting them.

 

[Jonathan Edwards]

Thanks, Jonathan. I asked because I just paid the bill for similar tests! (among many others, I should add). I'm going to assume that my doctor (Kenny de Meirleir) has good reasons for wanting them.

I have to say that I would like to understand why ME physicians ask for these tests and at present I do not.

 

[sarah darwins]

I have to say that I would like to understand why ME physicians ask for these tests and at present I do not.

Noted. If an answer emerges during my follow-up consult in August I'll let you know.

 

[heapsreal]

I have to say that I would like to understand why ME physicians ask for these tests and at present I do not.

While there is no diagnostic test for cfsme and nk function testing isn't available to everyone, lymphocyte subsets test can show a dysfunctional immune system which is a common finding and some type of pathology type evidence. Its not ideal but its all some have.

my dr also uses it to help diagnose active infections and track treatments with antivirals . We don't have access to viral titres here in australia through a gp, although i was able to get one lot of viral titres for cmv done about 7 years post cfs onset. Titres were elevated in a range indicating active cmv infection.

The cd8 t cells are commonly elevated in herpes viruses, so this cd8 came down while on famvir as well as other lymphocyte subsets. We stopped treatment and cd8 and all subsets increased as well as total lymphocytes. This test seems to correlate with improvements from antivirals for myself.