Fluctuation in tetanus toxoid antibody IgG titres during illness and well

[GreyOwl]

Hi.

My daughter received her last tetanus immunisation at the age of 4 years 0 months, on schedule. I have no concerns regarding vaccinations and request that the discussion on vaccinations in this thread stays on topic around how the immune response can be understood as a response to them.

At the age of 8 years and 6 months, immediately after her most recent "prolonged episodes of cough, congestion, nausea, loss of appetite and sometimes vomiting, fatigue, loss of weight and sterile pyuria" her tetanus toxoid antibody IgG titre was 1.77 IU/mL.

At the age of 10 years and 5 months, after 12 months of being well this was re-measured (same lab, same reference ranges) and this was found to be 0.8 IU/mL.

Is this a significant fluctuation in 23 months? What do IgG antibody titres fluctuate in response to? What does this indicate about an immune system?

We see the immunologist at some point in the near future, but thought I would ask while it's on my mind.

Thanks to anyone who read this far.

(edited for grammar)

 

[Gingergrrl]

I don't know the answer but bumping this for you @GreyOwl so more people will see it who might know

 

[GreyOwl]

Thanks @Gingergrrl

 

[GreyOwl]

We saw the immunologist this morning. He agreed that the fluctuation in TTAb was quite significant as it was a reduction of over 50%, well outside a 20% margin of error or natural fluctuation, but we didn't speak more about it. I will ask him more next time we see him.

We're planning a DBPC methylparaben challenge. If we're correct that this is the trigger for relapses, we'll expect to see a very significant increase in IgE, a significant increase in TTAb and a significant decrease in CD4 and CD8 naive T cells. There will be other mild abnormalities in blood (liver and bicarbonate) and significant inflammatory markers in urine.

Has anyone seen this constellation of immune marker changes?