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Holy crap -- IgM deficiency

E

Eeyore

Senior Member
Messages
595
You have to go by the reference ranges on your lab form, as different test methods will produce somewhat different results for the same person. The reference ranges are calibrated to the testing methods used.

I don't seem to have abnormal antibody levels. I have somewhat elevated IgA subclass 2 antibodies, but that's probably an incidental finding.

I do have high igE - which is generally associated with type 1 hypersensitivity.
 
JaimeS

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
Eeyore said:
You have to go by the reference ranges on your lab form, as different test methods will produce somewhat different results for the same person. The reference ranges are calibrated to the testing methods used.

I don't seem to have abnormal antibody levels. I have somewhat elevated IgA subclass 2 antibodies, but that's probably an incidental finding.

I do have high igE - which is generally associated with type 1 hypersensitivity.
Click to expand...

I have definitively high IgE as well! It's also associated with parasites! Isn't that exciting? :p

I thought it was you who was stating earlier how fluid the ranges were! LOL, in all seriousness, I do know that the tests may be done differently and that may alter the reference ranges. They were all still quite low, except for the IgE, even with that taken into account.

-J
 
E

Eeyore

Senior Member
Messages
595
Yeah reference ranges don't mean everything. Everything has to be interpreted in context with clinical picture and understanding of diseases and how they work.

You probably do have low-ish immunoglobulins. Not sure what that means though, and it doesn't seem to be a general ME phenomenon.

There have been reports of increased allergies in ME patients for many decades - there seems to be greater overlap than would be expected randomly. Dr. Bell talked about it a lot.
 
halcyon

halcyon

Senior Member
Messages
2,482
Eeyore said:
You probably do have low-ish immunoglobulins. Not sure what that means though, and it doesn't seem to be a general ME phenomenon.
Click to expand...
IgG1 and 3 subclass deficiencies seem to be hugely common around here. I believe a handful of research has shown this as well.
 
E

Eeyore

Senior Member
Messages
595
Interesting. I don't have that - but doesn't mean everyone else doesn't.

What do you mean by deficiencies? Absence, or just numbers a bit under the ref range?
 
JaimeS

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
Data!

Total IgG = normal (861-mg/dL, range = 767 - 1590).... although a second reading is 763.6...
IgG1 = lowish (360-mg/dL, range = 341 - 894) ... other ranges are much higher. Quest's is 382 - 929.
IgG2 = normal
IgG3 = normal
IgG4 = lowish (5-mg/dL, range = 2.4 - 121, or 4 - 86, depending)
IgM(s) = normal (139-mg/dL, range 37 - 286)
IgE = 298-kU/L (mean = 13.2... and that's what they list, no range is given. The web states that this is quite high.)

I had a separate reading for IgA awhile before this:

IgA = 75-ng/dL - range is 81-463-mg/dL

On my lab results, I have the following note in quotations that may be of interest to others:

"High IgE specificities coupled with low IgG4 specificities correlate well with documented resistance to re-infection [with Schistosoma mansoni]." I think I had found evidence that correlated this pattern with parasitic infection, either past or present.

-J
 
E

Eeyore

Senior Member
Messages
595
@JaimeS - IgG4 deficiency is the most common IgG deficiency, and because there isn't much of it found anyways, it's usually asymptomatic. Your numbers are probably normal for IgG, but repeat testing to see if you still have low numbers might be interesting. Immunoglobulins do jump around a lot over time, and most people if tested enough would probably have things above and below reference ranges. The IgA is slightly weirder but could definitely be a normal variant.

Your IgE number is definitely high (mine's over 400, so not too far off yours). Do you have a lot of allergies? Reactive airway disease / asthma?

Yes, as you mentioned, IgE can be associated with parasites, but this is not that common in the US. Do you have any abnormalities on your CBC (blood count)? In particular, eosinophil count (absolute if they have it there, else percent) - is it normal?
 
GONZ0hunter

GONZ0hunter

Senior Member
Messages
131
Location
Fragelle rock, USA
E

Eeyore

Senior Member
Messages
595
No. According to the Immune Deficiency Foundation, deficiencies are most common in IgG2, followed by IgG3.
Click to expand...

I think this might be a semantics question. It seems IgG4 deficiency may or may not actually matter and may have no symptoms, and may be very common, but not classed as a true deficiency since it just doesn't matter much. IgG2/3 deficiencies may be the more common clinically relevant ones.
 
justy

justy

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U.K
I have high IGE (so presumed allergy here in the UK) but also high IGM which no one is interested in.
 
E

Eeyore

Senior Member
Messages
595
Justy, has anyone run a serum protein electrophoresis on you, or an immunofixation electrophoresis?

I'm guessing your IgG is normal - there are hyper IgM diseases where B-cells can't class switch and as a result IgM remains high (very high often) but there is no IgG.
 
E

Ema

Senior Member
Messages
4,729
Location
Midwest USA
Eeyore said:
I think this might be a semantics question. It seems IgG4 deficiency may or may not actually matter and may have no symptoms, and may be very common, but not classed as a true deficiency since it just doesn't matter much. IgG2/3 deficiencies may be the more common clinically relevant ones.
Click to expand...
Certainly IgG2 and IgG3 deficiencies are better understood and have more studies but that isn't to say that IgG4 is meaningless. IgG4 is the least prevalent of the IgG subclasses and makes up only about 5%'of the total.

It has been associated with many disease conditions including diarrhea, asthma, adverse reactions to foods, chronic candidiasis, and autoimmune disorders.
 
E

Eeyore

Senior Member
Messages
595
IgG4 deficiency is probably worst when combined with IgG2 deficiency, as they tend to bind similar antigens (and IgG1 and IgG3 tend to bind similar antigens). I would think that normally, IgG4 deficiency would not be too much of a problem. That's somewhat speculative though.
 
SOC

SOC

Senior Member
Messages
7,849
Had my 3rd round of IVIG today. My labs as of 10 days ago (about 6 weeks after the previous infusion) show a small improvement in IgG and IgM and a small decrease in IgA (but still in range). The hematologist wants to keep me on a relatively low dose of IG based on that. Seems to me we should want more improvement in numbers than this, but I'm no immunologist. o_O

Labs from May 2015
IgG 687 (ref: 694-1618 mg/dl)
IgM 13 (ref: 48-271 mg/dl)
IgA 155 (ref: 81-463 mg/dl)

Labs from Aug 2015 (same reference ranges)
IgG 811
IgM 15
IgA 140

For some reason they are not running IgG subclass tests, so I don't know if my IgG subclasses are improving across the board or unevenly.

On the positive side, I am feeling better in many subtle ways, especially in the first month after the infusion. It's not huge, but noticeable.

I am expecting another round of immune and pathogen tests from INIM in October, so we'll see then if anything has changed in other immune indicators.
 
heapsreal

heapsreal

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10,099
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australia (brisbane)
SOC said:
Had my 3rd round of IVIG today. My labs as of 10 days ago (about 6 weeks after the previous infusion) show a small improvement in IgG and IgM and a small decrease in IgA (but still in range). The hematologist wants to keep me on a relatively low dose of IG based on that. Seems to me we should want more improvement in numbers than this, but I'm no immunologist. o_O

Labs from May 2015
IgG 687 (ref: 694-1618 mg/dl)
IgM 13 (ref: 48-271 mg/dl)
IgA 155 (ref: 81-463 mg/dl)

Labs from Aug 2015 (same reference ranges)
IgG 811
IgM 15
IgA 140

For some reason they are not running IgG subclass tests, so I don't know if my IgG subclasses are improving across the board or unevenly.

On the positive side, I am feeling better in many subtle ways, especially in the first month after the infusion. It's not huge, but noticeable.

I am expecting another round of immune and pathogen tests from INIM in October, so we'll see then if anything has changed in other immune indicators.
Click to expand...


Are you feeling better on the ivig??
 
E

Eeyore

Senior Member
Messages
595
@SOC - That's really interesting stuff! For one, it's amazing that you found a hematologist willing to treat an ME patient with serious medicine!

Dr. Jay Goldstein's first effective treatment for ME patients was IVIg. He used it on a lot of patients with very good results until he got too much pushback from the insurance companies - but it did seem to work.

Broadly, it's an anti-inflammatory. it's the treatment of choice in Guillain-Barre syndrome, which is the diagnosis I've gotten from a few neurologists.

Definitely keep us updated - I'm very curious to see how it works.
 
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