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Immune test results

Discussion in 'Diagnostic Guidelines and Laboratory Testing' started by SOC, May 21, 2015.

  1. SOC

    SOC

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    Just thought I'd throw some of my latest immune test results out there for comment. I have a lot more -- cytokines, and other lymphocytes -- but here are the more common (and mostly abnormal) ones.

    Because lab reference ranges vary and absolute numbers are sometimes difficult to understand, I've normalized my test results to the reference range, so 0 means I'm at bottom of the reference range and 100 means I'm at the top. Negative numbers (in red) mean I'm below the reference range.

    IgM -16
    IgA 19
    IgG -1
    IgG1 1
    IgG2 -2
    IgG3 9
    IgG4 22

    CD3+ -19
    CD4+ 18
    CD5+ -16
    CD8+ -18
    CD19+ 2
    CD56+ 101

    NK cell function 71

    As you can see, some of my immunoglobulins are below range and the highest is still in the bottom 25% of the range.

    Several of my lymphocyte classes are well below range and others are in the bottom 20% of the reference range. The exception is my NK cells which seem to be doing nicely, thank you, possibly due to supplements, or maybe just because they're happy little buggers.

    I've got loads of other immune data so if anyone is curious about cytokine levels or other lymphocytes, just ask and I'll look them up while I have the file out.

    Any thoughts?
     
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  2. leokitten

    leokitten Senior Member

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    Is your NK function in units of LU30? If so 71 is a great result I'm very happy for you. I can't get mine above 24.

    What supplements and/or treatment are you doing that you think have helped?

    Also glad you are doing IVIG you definitely need it.
     
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  3. SOC

    SOC

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    71 is the normalized number, meaning I'm in the top 30% of the reference range. I've actually been above, below, and in the top of the reference range over the past 3 years -- mostly near the top end of the range. NK cell function is one of the few immune issues I'm not struggling with.

    I suspect this product of having an effect on my NK cell function because I have heard the beta-glucans mushrooms and astragalus root can improve NK cell function. It's just a guess, though. My daughter takes this too, and she still has to take inosine to keep her NK cell function up. If I had to choose between the two, I'd take the inosine as that is what Dr Rey recommends for low NK cell function.
    Tell my insurance company that. :rolleyes: Apparently they're balking because I don't have "markedly low" IgG which is their criteria for IVIG. I believe they're eventually going to give in, but they're really making my hematologist fight for it.

    What about my lab results makes you say I definitely need IVIG? I'm not arguing :), I'm just curious what kind of arguments my hematologist is going to have to use to justify IVIG if it's not "markedly low" IgG.
     
    Last edited: May 21, 2015
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  4. leokitten

    leokitten Senior Member

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    Off the top of my head I would say your hematologist can make a good case by pairing these immune system results with other labs you've done showing that your immune system isn't suppressing infections and that you have chronic infections. Maybe this would help since they don't consider your IgG low enough.
     
  5. Ruthie24

    Ruthie24 Senior Member

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    I find myself having NK Cell Function Envy. ;)
     
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  6. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    They need to look at the big picture not just one single lab unit result . I guess thats losing the art of medicine instead its done by numbers and cost.
     
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  7. SOC

    SOC

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    Trade ya some immunoglobulins for some well-functioning NK cells. :cautious::ninja::cautious:
     
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  8. SOC

    SOC

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    Yeh. That's pretty much what the hematologist said -- that the big picture clearly shows I need IVIG and I need it ASAP. Unfortunately insurance companies are not good at big picture. They're all about numbers and cost. If they can find an excuse not to pay, they will.

    It's pretty stupid, though, since I'm likely to cost them more in the long run if I don't get the IVIG. But as I said, they're not good at seeing the big picture.
     
  9. Ruthie24

    Ruthie24 Senior Member

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    :rofl: I would be happy to but since I'm starting SCIG next week myself, not sure it would be a good trade for ya.:oops:;)
    .
     
  10. SOC

    SOC

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    Pfft! :rolleyes: Oh well, I can be generous, I seem to have enough well-functioning NK cells for both of us. The question is where are we gonna get some immunoglobulins? Wait, you ARE getting some next week!

    Now I have immunoglobulin envy. :cautious:
     
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  11. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    All i want is granulocyte stimulating factor to increase my neutrophils :(
    I would settle for ivig too or ampligen?
     
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  12. Ruthie24

    Ruthie24 Senior Member

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    So...best laid plans and all that....
    Just got an email from my doc suggesting I hold off starting the SCIG until after my son's wedding the end of June. He's worried side effects will be problematic.

    SOC- sounds like you'll likely be getting it first. :thumbsup:
     
  13. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    What sort of sides? Are there die off symptoms from IG
     
  14. Jonathan Edwards

    Jonathan Edwards "Gibberish"

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    Clin Rev Allergy Immunol. 2005 Dec;29(3):173-84.
    Intravenous immunoglobulin: adverse effects and safe administration.
    Orbach H1, Katz U, Sherer Y, Shoenfeld Y.
    Intravenous immunoglobulin (IVIg) is administered for various indications and generally considered a safe therapy. Most of the adverse effects (AEs) associated with IVIg administration are mild and transient. The immediate AEs include headache, flushing, malaise, chest tightness, fever, chills, myalgia, fatigue, dyspnea, back pain, nausea, vomiting, diarrhea, blood pressure changes, tachycardia, and anaphylactic reactions, especially in IgA-deficient patients. Late AEs are rare and include acute renal failure, thromboembolic events, aseptic meningitis, neutropenia, and autoimmune hemolytic anemia, skin reactions, and rare events of arthritis. Pseudohyponatremia following IVIg is important to be recognized. Renal failure, usually oliguric and transient, occurs mostly on using sucrose-containing products owing to osmotic injury. Among high-risk patients who have a previous renal disease, dehydration, diabetes mellitus, advanced age, hypertension, hyperviscosity, or are treated by other nephrotoxic medications, administration of a non-sucrose-containing IVIg product after accomplishing hydration, in a low concentration and a slow infusion rate while supervising urine output and kidney function, is recommended. Thromboembolic complications occur because of hyperviscosity especially in patients having risk factors including advanced age, previous thromboembolic diseases, being bedridden, diabetes mellitus, hypertension, dyslipidemia, or those receiving high-dose IVIg in a rapid infusion rate. Immediate AEs can be treated by the slowing or temporary discontinuation of the infusion and symptomatic therapy with analgesics, nonsteroidal anti-inflammatory drugs, antihistamines, and glucocorticoids in more severe reactions. Slow infusion rate of low concentration of IVIg products and hydration, especially in high-risk patients, may prevent renal failure, thromboembolic events, and aseptic meningitis.
     
  15. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    @Jonathan Edwards
    have you seen cases of neutropenia specifically from ivig?

    Sounds contradictory too many but, Have you seen cases where ivig has been used successfully for autoimmune neutropenia ?

    Cheers
     
  16. justy

    justy Donate Advocate Demonstrate

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    I hope you get your ivig soc.

    My NK cell activity is High and I also have raised IGM - not that my GP is interested in that.
     
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  17. Jonathan Edwards

    Jonathan Edwards "Gibberish"

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    Rheumatologists generally gave up using IVIG in the 1980s because it was expensive, not very effective (if at all) and causes reactions - there was also a huge concern when HIV and Hep C hit the headlines - which died off a bit until we realised that even proteins can transmit lethal diseases (BSE).

    So I have used IVIG very rarely. I only remember two cases clearly. One had very troublesome reactions but she had to carry on because her IgG was 3gm/litre and she had active bronchiectasis. To be honest you would have to twist my arm pretty hard to suggest giving IVIG unless there was very solid grounds. In the UK it is very hard to get enough Ig to treat the congenitally agammaglobulinemic children who need it to survive. In developing countries I suspect most such children die because IVIG is too expensive. There is a suggestion that IVIG is useful in ME but not because of low immunoglobulins on testing or immunodeficiency. I would like to see that confirmed in a good trial.

    So I have not personally seen neutropenia with IVIG but neutropenia is one of the common effects of immune reactions to drugs. Nor have I seen IVIG used for autoimmune neutropenia - but it is pretty hard to prove neutropenia is autoimmune. The review article posted on a thread recently quotes some studies from years ago and to be honest I am not sure we really know that there is such a thing as autoimmune neutropenia on its own - although we know that neutropenia is a major feature of one autoimmune disease - lupus. On the other hand autoimmune thrombocytopenia is well documented and is one of the things that responds best to rituximab - even with long term cure. So there may well be rarer parallel neutropenia cases.

    A benefit of rituximab on autoimmune neutropenia would make sense as much as in other antibody mediated diseases. One of the ways antibodies cause problems is to form complexes in the circulation. These get cleared by attaching to receptors on the surface of red cells, white cells and platelets. These cells are then 'cleaned off' in the spleen. However, the platelets tend to get binned in this situation - so lots of complexes produces thrombocytopenia. The same occurs for neutrophils with massive complex overload as in meningococcal septicaemia. So getting rid of complexing antibodies could help both. Equally if there are autoantibodies to neutrophil surface proteins then getting rid of these would help - and that might be more relevant to isolated neutropenia. If the neutrophils are being destroyed at birth in bone marrow the mechanism is different again but similarly removing the binding antibodies would help.
     
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  18. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    Thanks for that reply JE.

    the autoantibody on surface cell of neutrophils, is this how steroids increase neutrophils(short term) ? Or could there also be some type of autoimmune issue going on in bone marrow also?

    if there was a bone marrow issue would one see a drop in all white blood cells and lymphocytes or could this just be isolated to just neutrophils ?

    Cheers
     
  19. Jonathan Edwards

    Jonathan Edwards "Gibberish"

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    Steroids increase neutrophils in healthy people. They do that by shutting down expression of adhesion molecules on blood vessels (ICAM-1, E-selectin, VCAM-1 etc) so the neutrophils have nothing to stick to and just keep going round and round in the circulation. In immune complex disease steroids may also inhibit splenic ingestion of coated neutrophils but I am not sure I have heard of that being documented.

    Destruction of neutrophil precursors in bone marrow can be isolated. Isolated agranulocytosis (no neutrophils) occurs in reactions to drugs that probably involve haptenisation and immune damage to neutrophil precursors in marrow.

    The mechanisms of neutropenia are extremely complicated. In rheumatoid disease the neutropenia that occurs as part of Felty's syndrome (RA, splenomegaly, neutropenia) probably has three different mechanisms, involving hypersplenism, large granular lymphocytosis in marrow and immune complex mediated consumption.
     
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  20. lansbergen

    lansbergen Senior Member

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    The immune modulator I use can cause agranulocytosis and that reverses when one stops taking the med.
     

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