Immune test results

[heapsreal]

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.

Do u find in RA pts in general as well as RA with felty's have an increased incidence of URTI and UTIs.

in my line of work most of the autoimmune pts appear to be prone to infections as above or cellulitis etc but most also are on steroids long term, maybe increase infectious risk? Maybe it just appears that way as thats when im in contact with autoimmune pts when they are febrile/septic and later i find many are neutropenic, unsure if cause or effect of neutropenia .

 

[halcyon]

One of the ways antibodies cause problems is to form complexes in the circulation.

The UK researchers seemed to often find increases of circulating immune complexes in ME patients. I've never heard of any US investigators even looking for them.

 

[Jonathan Edwards]

The UK researchers seemed to often find increases of circulating immune complexes in ME patients. I've never heard of any US investigators even looking for them.

Years ago there were lots of papers about 'immune complexes' in all sorts of diseases but the assays were very dubious and are probably best forgotten. A minority of 'ME' patients may have variants of Sjogren's or lupus that do not show up in the typical way and they may have some complexes but my thinking is that the symptoms of ME do not look as if they are mediated by complexes. Complexes either deposit - mostly causing rash or kidney problems, or activate macrophages - mostly producing arthritis or pericarditis or splenomegaly.

The story of immune complexes deserves revisiting one day - especially in conditions like polymyalgia rheumatica, but maybe not in ME.

 

[SOC]

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.

This is getting goofy. We all get to talk about getting immunoglobulins, we just don't get to have them actually put in our bodies. Maybe this is all part of the "knowledge" of PWMEs' supposed amazing psy powers to think ourselves sick or well. All we have to do is think about getting immunoglobulins, and voila, renewed health!

What side effects is he expecting? My heme says there shouldn't be any significant side effects other than those related to the infusion itself. My daughter is getting married mid-July and I don't want to be in the middle of a side effect problem at that time.