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CD8 CD56 CD3 high CD4 low

Discussion in 'Immunological' started by Richard7, Feb 19, 2015.

  1. Richard7

    Richard7 Senior Member

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    Hi,

    I had some pathology done, and it clearly concerned my specialist but I'm not entirely sure I understand it. My lymphocytes are normal 2.4x10*9/L (range 1.0-4.0) but the proportions are off: CD3 is 84 (range 60-82); CD4 is 29 (range 34-55); CD8 is 51 (range 19-42); and CD56 is 25 (range 1-15). Neutrophils were 5.3 (range 1.8-7.7) monocytes 0.6 (range 0.1 - 0.8) eosinophils 0.3 ( <0.6) and basophils 0.1 (<0.3). So it would seem, from what I have been able to work out, or think I have, that my immune system is normally active but killing infected cells rather than using antibodies etc.

    I know from http://forums.phoenixrising.me/inde...lls-perforin-and-glutathione-depletion.17603/ that people with CFS tend to have less effective CD8s and CD56s and was thinking that that could be the cause, but I can also see that other people have generally reported high CD4/CD8 ratios.

    Does anyone have any ideas or, better still, knowledge?

    Thanks
     
    Aidan Walsh likes this.
  2. halcyon

    halcyon Senior Member

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    As you probably know, cytotoxic T cells express CD8 so an elevation of those could be a sign of active infection. I'm not certain, but elevated NK (CD56+) cells could also be a sign of this. Indeed in my case my CD8+ T cells were persistently elevated and I have a confirmed chronic enterovirus infection.

    What sort of infectious disease testing have you had done so far?
     
  3. Richard7

    Richard7 Senior Member

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    halcyon,
    I had some testing done a year and a half ago that showed that I did not have Barmah Forest virus or Epstein Barr (though the pathology showed that I had had it previously) I have also been tested for Ross River which was also a negative.

    I became ill in 2013 and was tested for heavy metals and a bunch of other things, but the knowledge of the condition was different and the pattern in the pathology was different, CD3 was high normal 77, CD4 was low normal 38 and CD56 was low normal 6. The conclusion then was that the chronic migraine which started in February had caused the chronic fatigue which started in April or May. This may still be the right conclusion I don't know.

    At the moment I am sort of emerging from several years of severe brain fog and have had the luck to do so at a time when there is a doctor in town who is interested in CFS. He sent me out for this pathology, and I expect he will send me out for other pathology but other work commintments (his, I cannot work) mean my next appointment is in April, and I am curious now. Moreover, he sounded serious and offered to refer me to a specialist in another city to look into it immediatley, I'm too sensitive to migraine triggers (glare and pattern glare) to travel, and I'm feeling ill but a kind of ill thats better then any other I have felt in 5 or 6 years, well aside from my anxiety which is higher.

    In our last appointment he did ask me to keep track of basal temperature and heart rate, and they both seem to be low 34.5 - 35.5C (auxilary) mid 40s to mid 50sBPM most mornings, I am somethimes colder and slower when I am having a rest in the afternoon than I am in the morning. I have noticed that when I feel I have a fever, or sore joints or burst into a fit of sneezing my temperature is still low say 35.75 - 36.5. But I have the usual long list of symptoms, and I do not really know what is and is not relevant. There was a major change in late november when I woke up from the brain fog, had much higher anxiety and found I could not sleep once the sun was up, if this was caused by contracting a virus I'm truly grateful.

    Richard
     
  4. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    elevated cd8 is common in herpes viruses like ebv/cmv.
    cd56 and cd3 are nk cells so being high could mean they are fighting a viruses also, be interesting to get an nk function test if possible. Strange that your total lymphocytes are not high also??
     
  5. halcyon

    halcyon Senior Member

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    My suggestion would be to have a full workup for the pathogens most closely associated with ME. From the ICC primer:

    1. Infectious agents associated with ME
    Viruses:
    ● Enterovirus
    ● Epstein Barr virus (EBV)
    ● Human herpes virus (HHV 6 and 7)
    ● Cytomegalovirus
    ● Parvovirus B19

    Bacteria:
    ● Chlamydophila pneumonia
    ● Mycoplasma
    ● Coxiella burnettii
     
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  6. halcyon

    halcyon Senior Member

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    I don't believe this is unusual, especially during chronic infections. My lymphocyte count hasn't been elevated once since becoming sick. Even during the acute infection, my lymphocyte count was low (aka transient lymphocytopenia, known to be associated with enterovirus infections) instead of high.
     
  7. Richard7

    Richard7 Senior Member

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    yeah, I was hoping that this was a good thing, but I have read Halcyon's comment.
     
  8. Richard7

    Richard7 Senior Member

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    Thanks

    In my vagueness I failed to mention that the specialist said he may have to look at my bone marrow. He has me keeping a symptom diary and says he will call me from time to time with questions and may send me off for more pathology before we next meet. He also said that most people would immediatley put me on drugs to suppress the immune system, but that that would stuff up the pathology and make it hard to find the cause.

    Anyway I have looked up the viruses, and bacteria in wikipedia and downloaded the ICC primer, I guess I have some reading to do.
     
  9. halcyon

    halcyon Senior Member

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    Interesting, did he say why?

    It could also be a really bad idea depending on what's really wrong with you. If you have an active infection going on suppressing your immune system could cause it to get worse.
     
  10. Richard7

    Richard7 Senior Member

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    I don't know. I assumed that he wanted to look at the bone marrow to get a better understanding of what is happening to my immune system. He mentioned that he has had to do this with several other CFS patients. And I have a history of what I now know to be autoimmune conditions dermititis and restless leg, so that he would be looking at the immune system does not suprise me, but I have no idea of how he is meant to do such things.
    I guess it might help if I explain that in my first meeting he said that he does not belive that CFS is one thing but a box that doctors put a lot of conditions into (my metaphore not his) and that he would look for a cause and he thought, based on his experience, that he had a 50% chance of doing so. When he saw these results he said he thought I might have something on top of the CFS and the migraine.

    I do have an active fungal infection going on, skin and mouth, but I understand that that is a CD4 thing not a CD8 thing, or think I do, I have been reading about this and watching videos trying to get a handle on this but I'm not there yet.
     
  11. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    i thought it was strange in comparison to myself and other i have spoken too.
    its the cd t cells which make up the total lymphocytes, so generally speaking if cdT cells were high, would see total lymphocytes elevated or atleast high normal, Richards is in the low normal range. I have know idea if it relevant or not just different to what i have seen.

    In my observation of others who have low lymphocytes or cd t cells, generally have hhv6, but the above test results arent really in that group, could be wrong. Interesting to have a serious of these tests a few months apart and see if there is a pattern??
     
  12. halcyon

    halcyon Senior Member

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    Right, but the total lymphocyte count is the combination of CD4+ and CD8+ T cells. His CD4+ count is slightly low and his CD8+ count is slightly high. You'd likely have to have a very large increase in either or both T cell populations to increase the total lymphocyte count.

    Which, the subset test or total count test?
     
  13. halcyon

    halcyon Senior Member

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    This is the best I can do. While I had a ton of CBCs, I only had two lymphocyte subset tests and fairly close together.

    lymphs.png
     
  14. Richard7

    Richard7 Senior Member

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    Halcyon did you have any change in symptoms or treatment between july and august?
     
  15. Richard7

    Richard7 Senior Member

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    Ok, this seems weird. I have just been looking through some pathology from before I got CFS in 2000-2002. In 2000 I had pnuemonia and in 2001 and 2002 I had recurrent throat infections and sinusitus. All of the heamatology is normal range. So I had pnuemonia and my wbc was 5.1 (range 4-11) neutrophils 2.6 (range 2-7.5) lymphocytes 1.8 (range 1.0-4.0) monocytes 0.4 (range 0-1) basophils 0.1 (range 0-.3). ESR was 5 (range 0-16) which would suggest that I was not inflammed.
     
  16. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    My total lymphocyte go high above the 4s when off antivirals, which i havent much over the last few years but otherwise my total lymphocytes were in the 3s.
    Cd3/4/8 consistently high all the time but were higher off antivirals with a trend of lowering on antivirals. Had the odd test where one of them would be normal?
    I have had 19 of these tests done since 2007, with a trend showing the elevated numbers improved on antivirals and worsen if off.
     
  17. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    ESR isnt the only marker of inflammation but use it as a guide. All your numbers seem within range but if you had an infection you would expect neutrophils to be above range or below and lymphocytes arent doing alot to help fight any infections. Maybe a sign your immune system was tiring trying to fight a chronic infection but hard to say?
     
  18. halcyon

    halcyon Senior Member

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    I was quite sick during that time period with frequent fevers and other viral symptoms.
     
  19. halcyon

    halcyon Senior Member

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    When did your ME start?
     
  20. Richard7

    Richard7 Senior Member

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    Oops, I just realised that at #3 I said I bacame ill in 2013 I meant to type 2003.

    But following the pnuemonia I had major issues with dyspepsia and fatigue and dropped to working 4 days a week. In the second half of 2001 I saw a doctor who gave me vitamin injections, explained that the dyspepsia was making me malnourished even though I had put on a lot of weight, and I did get better. But I was not really well until I left that workplace and got out of fluorescent lighting for a while. (I am a migrainer who is triggered by glare and pattern glare and fluorescent lighting is a type of pattern glare.) Looking back I can see that periods of ill health in the 90s were probably brought on by a combination of the damage done by the fluoros and the psychological stress that this put on me, and that they had some similarities to CFS.
     

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