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B cell test interpretation

Discussion in 'Diagnostic Guidelines and Laboratory Testing' started by Learner1, Nov 6, 2017.

  1. Learner1

    Learner1 Professional Patient

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    Can anyone help me understand this? It seems "normal" but I know that on other tests, just because one is in the normal range doesn't mean there isn't a problem.

    Thanks for any interpretive help.:)

    RESULTS: B Cell Immunophenotyping by Flow Cytometry:

    [ CD19 B cells (of Lymphs): 16.7% (Ref. Range: 6.0-19.0%)].
    [ Memory B cells (of CD19): 27% (Ref. Range: 8-48%)].
    [ Naive B cells (of CD19): 73% (Ref. Range: 48-95%)].
    [ Mature Memory B Cells (of CD19): 23% (Ref. Range: 8-48%)].
    [ Functional Mature Naive B Cells (of CD19): 77% (Ref. Range:
    48-95%)].
    [ Immature/Transitional B cells (of CD19) : 0.8% (Ref. Range:
    0.6-9.0%)].
    [ IgM IgD c-s mem B Cells of CD19+CD27+: 42% (Ref. Range: None Provided)].
    [ IgM IgD c-s mem B Cells (of CD19): 11.6% (Ref. Range: 6.0-30.0%)].
    [ Anergic Activated B cells (of CD19): 0.6% (Ref. Range: 0.0-10.0%)]
    [ IgG c-s mem B Cells (of CD19+CD27+): 13.2% (Ref. Range:
    10.0-80.0%)].
    [ IgA c-s mem B Cells (of CD19+CD27+): 20.1% (Ref.Range: 5.0-40.0%)].
    [ IgG:IgA (class-switched Memory B ratio): 0.7 (Ref. Range: 0.5-3.5)].
    [ Plasmablasts (of CD19): 0.1% (Ref. Range: 0.0-4.0%)].
    [ CD20 B Cells (of Lymphs): 16.6% (Ref. Range: 6.0-19.0%)].
    [ CD20+ B Cells (of CD19): 100% (Ref. Range: 90-100%)].
    [ BAFF-R+ B Cells (of CD19): 100% (Ref. Range: 90-100%)].
    [ BAFF-R Median Fluorescence Intensity: 33.67 (Ref. Range:
    25.00-75.00)]
     
  2. Gingergrrl

    Gingergrrl Senior Member

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    I don't know how to interpret it and have never seen such a detailed B cell test! The one that I do to monitor B cells every four weeks (for Rituximab) is the "lymphocyte subset panel" but it is totally different than the test that you did above. Was your test ordered for possible Rituximab or another purpose? Can your doctor help you to interpret it? The only thing I know from my test is that there are two sets of numbers (for both B cells and T cells) and one is the "absolute" number and one is a percentage.
     
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  3. Learner1

    Learner1 Professional Patient

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    I don't have an appointment with that doctor for 3 weeks... Just trying to be prepared;)

    I didn't know he ran it and haven't seen one before either...

    Just curious, thanks!
     
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  4. rodgergrummidge

    rodgergrummidge

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    Such a specific and detailed panel! It would be good to know what the doc was investigating. Such a B-cell analysis might be informative if you had post-viral CFS? Are you post-viral? EBV? Other? If so, abnormal B-cell numbers or expression patterns could provide important clues. For example, if you had abnormal numbers/%, it might point toward latent viral infections which would be informative for diagnosis and/or treatment.

    Rodger
     
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  5. Gingergrrl

    Gingergrrl Senior Member

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    @Learner1 Was it our doc who ordered that panel for you or another doc? I think in my case w/Ritux, he is just checking that B cells are staying at zero between infusions which, so far, has been the case. But I am curious to hear more once you know it!
     
  6. Learner1

    Learner1 Professional Patient

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    I have low IgG, IgM, and NK cells. Also 5 viral and 2 bacterial chronic infections. And celiac, Hashimotos, adrenergic, and muscarinic antibodies. And MCAS. And I'm on IVIG, antivirals and antibiotics.
     
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  7. Learner1

    Learner1 Professional Patient

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    Its the back up immunologist I found near me, in case I get into trouble, not our doc.

    Not sure what he's driving at. He agrees I need IVIG, but wasn't totally following the rest of my diagnoses and treatment.

    Edited to add:
    I found this paper which discusses B cells and categorizing common variable immune deficiency, which is a heterogeneous disease. I'm puzzling over it and comparing to my results, but it seems to match up with the B cell test. Lots to learn...

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2922984/#!po=48.6667
     
    Last edited: Nov 7, 2017
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