Antibodies gone crazy

[Marky90]

Hi!

I was checking up some blood work with my doctor, and to both our surprise we discovered that i had elevated antibodies to whooping cough, which i had 10 years ago!? im not recently vaccinated.

I did a nasal test to see if im undergoing a reinfection which will come back in a few days.

What im wondering is: if i dont have an infection, but elevated antibodies, is that a possible cause for fatigue?

My doctor just said that this supports the autoimmunity thesis, with regards to antibodies acting crazy.

Feedback is must appreciated!

 

[Snow Leopard]

Hi,

Which antibodies and which test? Some tests, unfortunately have a potential for false positives?

A positive IgG antibody result simply suggests that you had pertussis (or a vaccination) sometime in the past. Whereas very high levels of IgM (not necessarily just above the cutoff) suggests an ongoing infection. If you don't actually have an ongoing infection, then that is obviously cause for concern and it may be worth getting re-tested.

 

[Jonathan Edwards]

Hi!

I was checking up some blood work with my doctor, and to both our surprise we discovered that i had elevated antibodies to whooping cough, which i had 10 years ago!? im not recently vaccinated.

I did a nasal test to see if im undergoing a reinfection which will come back in a few days.

What im wondering is: if i dont have an infection, but elevated antibodies, is that a possible cause for fatigue?

My doctor just said that this supports the autoimmunity thesis, with regards to antibodies acting crazy.

Feedback is must appreciated!

I think it probably just means you have very good immunity to whooping cough. Antibodies to the pertussis bacterium would not in themselves be expected to cause fatigue. And I don't think they would have anything to do with autoimmunity. In autoimmunity some antibodies go crazy but only very specific ones. Strange things can happen to antibodies to bacteria but only in very specific diseases in specific ways. I don't think this really supports an autoimmunity thesis to be honest.

 

[Marky90]

I think it probably just means you have very good immunity to whooping cough. Antibodies to the pertussis bacterium would not in themselves be expected to cause fatigue. And I don't think they would have anything to do with autoimmunity. In autoimmunity some antibodies go crazy but only very specific ones. Strange things can happen to antibodies to bacteria but only in very specific diseases in specific ways. I don't think this really supports an autoimmunity thesis to be honest.

Okey! Thank you so much for the insight! Im sure youre right I didnt know antibodies remained in high numbers after such a long time! I thought you primarily needed the memory b-cells? But then again my immunological understanding is very shallow..

 

[Marky90]

Hi,

Which antibodies and which test? Some tests, unfortunately have a potential for false positives?

A positive IgG antibody result simply suggests that you had pertussis (or a vaccination) sometime in the past. Whereas very high levels of IgM (not necessarily just above the cutoff) suggests an ongoing infection. If you don't actually have an ongoing infection, then that is obviously cause for concern and it may be worth getting re-tested.

Ah ok! It was indeed for igG Might do another test if i dont have a current infection!

 

[Marky90]

Ok so it turned out i have whooping cough. Is this likely to be partly due to my igG2 subclass deficency @Jonathan Edwards? Just curious

 

[Marky90]

Fascinating that the antibodies were elevated weeks before i had symptoms..

 

[SOC]

Ok so it turned out i have whooping cough. Is this likely to be partly due to my igG2 subclass deficency @Jonathan Edwards? Just curious

So not just "very good immunity to whooping cough" after all? I'm glad your doctor didn't just dismiss the results without following up. Sorry to hear you actually have whooping cough, though. That can't be pleasant. Is there a treatment available?

 

[Marky90]

So not just "very good immunity to whooping cough" after all? I'm glad your doctor didn't just dismiss the results without following up. Sorry to hear you actually have whooping cough, though. That can't be pleasant. Is there a treatment available?

I actually just went to the E.R and said i have whooping cough, give me antibiotics. The doctor was very sceptical (as always lol), so i ordered a CRP and that showed i had an infection, and i was prescribed erythromycin. Took my first dosage yesterday, and im feeling much better today

 

[SOC]

I actually just went to the E.R and said i have whooping cough, give me antibiotics. The doctor was very sceptical (as always lol), so i ordered a CRP and that showed i had an infection, and i was prescribed erythromycin. Took my first dosage yesterday, and im feeling much better today

That's good news! So all you need is a fairly common antibiotic? That's fortunate. Glad you're feeling better already and hope you are over it completely very soon.

 

[Marky90]

That's good news! So all you need is a fairly common antibiotic? That's fortunate. Glad you're feeling better already and hope you are over it completely very soon.

Yep! Seems like it Thank you so much!

 

[Jonathan Edwards]

Ok so it turned out i have whooping cough. Is this likely to be partly due to my igG2 subclass deficency @Jonathan Edwards? Just curious

Did you get a positive culture for bordetella pertussis? And did you have a cough? What is your IgG2 level?

 

[Jonathan Edwards]

Actually, it looks from pubmed as if people do not make IgG2 antibodies to pertussis - only IgG1 and IgG3 so your IgG2 level does not look to be an issue. Clearly you had made a good IgG1 response before the recent symptoms.

 

[Marky90]

Actually, it looks from pubmed as if people do not make IgG2 antibodies to pertussis - only IgG1 and IgG3 so your IgG2 level does not look to be an issue. Clearly you had made a good IgG1 response before the recent symptoms.

Interesting - thanks for finding that out! Seems ive been wrong about pretty much everything haha!

 

[Snow Leopard]

Um, did you actually have the defining symptoms for whooping cough? You didn't mention that.
http://en.wikipedia.org/wiki/Pertussis

Otherwise, it sounds like you are simply being treated for an (unspecified) bacterial infection.

 

[Marky90]

Um, did you actually have the defining symptoms for whooping cough? You didn't mention that.
http://en.wikipedia.org/wiki/Pertussis

Otherwise, it sounds like you are simply being treated for an (unspecified) bacterial infection.

Hey i dont know for sure until tomorrow when the test comes back, but i had the same symptoms as last time, albeit somewhat subdued comparatively.

 

[Marky90]

Did you get a positive culture for bordetella pertussis? And did you have a cough? What is your IgG2 level?

My igG2 level is 1.33 g/L (reference area: 1.69-7.86)
Also have borderline IGM at 0.43 g/L (reference area 0.40-2.1)

Im gonna use the above to to get IVIG treatment, its probably the only hope i have while waiting for rituximab. I can of course just get better, have only been sick for one year with one relapse. Fingers crossed (but not sure that helps^^)

 

[Eeyore]

I'm very confused as to how anyone came to the conclusion that you had a whooping cough infection.

Elevated IgG only means you have past exposure and/or vaccination. It can be found in active pertussis but is also found in most of the population.
CRP is a nonspecific measure of inflammation - so its elevation could indicate many things, including infection, autoimmunity, and other conditions. CRP is not a diagnostic test for pertussis.
I think the doc may have figured you might have some kind of infection and trying some erythromycin might be worth it, and if you got better, great, if not, they could further investigate the elevated CRP.

Did you have symptoms of pertussis specifically?
Did your culture come back positive for it?

This touches on a lot of the questions there have been in recent threads regarding advice given on these forums, and why we have to be so careful. You reported elevated pertussis antibodies, but did not report pertussis symptoms or positive culture, so the natural interpretation by Dr. Edwards or any other doctor would be that you just have immunity. If you did have symptoms of pertussis or a positive culture, that changes the picture entirely. Fever would change the picture as well. This is why it's very hard to be a doctor on this site (I'm not one) - you are asked to give information/advice, but without all the necessary knowledge to do so. This is why we all need to maintain relationships with treating physicians and not use the board as a substitute for actual medical care.

The other thing that's weird is that most docs would look at a white count for a bacterial infection, not order a CRP...

The whole story is just very confusing.

 

[Marky90]

I'm very confused as to how anyone came to the conclusion that you had a whooping cough infection.

Elevated IgG only means you have past exposure and/or vaccination. It can be found in active pertussis but is also found in most of the population.
CRP is a nonspecific measure of inflammation - so its elevation could indicate many things, including infection, autoimmunity, and other conditions. CRP is not a diagnostic test for pertussis.
I think the doc may have figured you might have some kind of infection and trying some erythromycin might be worth it, and if you got better, great, if not, they could further investigate the elevated CRP.

Did you have symptoms of pertussis specifically?
Did your culture come back positive for it?

This touches on a lot of the questions there have been in recent threads regarding advice given on these forums, and why we have to be so careful. You reported elevated pertussis antibodies, but did not report pertussis symptoms or positive culture, so the natural interpretation by Dr. Edwards or any other doctor would be that you just have immunity. If you did have symptoms of pertussis or a positive culture, that changes the picture entirely. Fever would change the picture as well. This is why it's very hard to be a doctor on this site (I'm not one) - you are asked to give information/advice, but without all the necessary knowledge to do so. This is why we all need to maintain relationships with treating physicians and not use the board as a substitute for actual medical care.

The other thing that's weird is that most docs would look at a white count for a bacterial infection, not order a CRP...

The whole story is just very confusing.

Hi! I did have symptoms of whooping cough, and they did subside with antibiotics

 

[Eeyore]

Ok - that would have been good to include! Whooping cough is usually not too hard a diagnosis to make just based on clinical presentation - it's not a subtle disease generally!