Immunoglobulin G Activity - Help!

[Melissa89]

I have high immunoglobulin G and cd4 of 1200 so something is going on with my busy immune system. Thankfully they were only polyclonal antibodies and my immunologist explained that it’s a database of previous infections and antibodies. I didn’t think too much of it at the time because he was very relaxed about it at all.

Apparently they tested my immunoglobulin cells for the big things - cancers, MGUs and HIV (western blot) and there were zero antigens/antibodies related to any of those diseases. They didn’t delve any further as they eliminated any ‘serious’ causes.

My question is: is there any test I can do now to see what antibodies are present in that “database”? I’m wondering why there are so many and I’m a little bit concerned that my igg titres are so high.

EDIT: Ideally I’d just love to find out what my body has built such high immunity to!? I’m aware there is a maternal transfer of iGG1 and igg2 through the placenta and id like to prepare myself for having healthy children in the next couple of years.

Thank you!!

 

[Gingergrrl]

That is interesting and do you also test high for IgM or only for IgG? I had elevated IgM for several years and my doctor also tested me to rule out MGUS and cancer.

The tests came back normal and now my IgM is finally normal, too, and no longer elevated. He thought it was all autoimmune mediated (in my case) b/c I test positive for so many weird autoantibodies.

 

[Melissa89]

Hi ginger!

My iGM is surprisingly normal and low-ish. But my iGG1 & 2 were high. I think my next step is testing ANA’s... I was a bit worried because my doc said that there is a maternal transfer of the IGG and I really don’t want my children to inherit anything that is “unknown” to us right now. My partner thinks I’m being crazy but I really want to make sure about what bacteria / viruses may be living in there.

Is there a direct test to see what lives in the immunoglobulin G? I have made high antibodies to ebv & cmv, so my doctor is certain that if it was anything sinister they would have found it. But I am consistently returning with normal iGA, iGE, iGM but a very whacked out iGG!

 

[Gingergrrl]

and cd4 of 1200

I missed this part from your first post which led me to check my cd4 level out of curiosity (from a recent Lymphocyte Subset Panel which I do every six months right before I get maintenance infusion of Rituximab). My most recent (Absolute) cd4 was 545 which was considered "normal" and the reference range (for Quest) for cd4 was 490 to 1740. So using Quest's reference range, your cd4 of 1200 would be considered normal. Are you in the US? I was curious if the lab range is very different for you? I can tell you other numbers from my Lymphocyte Subset Panel if it is useful?

My iGM is surprisingly normal and low-ish. But my iGG1 & 2 were high.

My most recent IgM was 166 (with Quest) and the normal range is 50 to 300. For several years it was very elevated for me and I am shocked to now see it at 166. I'm assuming my overall treatments for autoimmunity helped to bring it down.

My most recent IgG subclasses were all normal and I'm assuming you mean that subclass 1 & 2 were high for you but 3 & 4 were normal?

I think my next step is testing ANA’s...

I think this is a good idea and knowing if your ANA is positive will be useful info. If possible, I would use a specialty rheumatology lab vs. Quest for this test. My ANA had been 1:160, speckled pattern, but is now normal 1:40 after all my treatments for autoimmunity.

Is there a direct test to see what lives in the immunoglobulin G?

I actually have no idea! Did you ask your immunologist? I do know that (in my case) after having two years of IVIG, standard antibody tests will never be considered accurate again.

I have made high antibodies to ebv & cmv, so my doctor is certain that if it was anything sinister they would have found it.

What else did he test you for besides EBV and CMV? I had very high antibodies to EBV for 3-4 years following severe Mono but have never tested positive for CMV. Back at that time I was also tested for the other herpes viruses (1&2, VZV, HHV-6, etc) plus parvovirus, enteroviruses, and bacterias like CpN, mycoplasma, Lyme and tick-borne infections, and probably others that I am not remembering.

But I am consistently returning with normal iGA, iGE, iGM but a very whacked out iGG!

I am hoping your immunologist can interpret all of this for you. I had elevated IgE for many years but I also had severe allergic reactions, including anaphylaxis, from MCAS so the high IgE made sense. The elevated IgM was a mystery and my doctor felt it must have been due to autoimmunity in my case. My IgA and IgG were always normal (with the exception of one test in 2015 or 2016 in which my IgG 3 was low).

 

[Melissa89]

@Gingergrrl thanks for all the info!! The thing is my immunologist just wrote it off as being “unremarkable” because they eliminated anything malignant and infectious. He is very expensive so I’m reluctant to go back unless I am diagnosed with something autoimmune which I can leave in the hands of my capable gp.

He essentially tested me (comprehensively) for anything that can cause high igg - ebv, cmv, hhv6 (I was inoculated) and hepatitis / hiv. The only positive antibodies were to cmv and ebv. No hsv1 or hsv2. High antibodies to Hepatitis B (immunisation >1000).

My cd4 floats anywhere from 1200 to sometimes as high as 2000 with a 1.9-2.4 ratio (normal). My cd8 is always a consistent 600-800 and is not activated. I do megadose iv vitamin c and antioxidants and I asked if this could be a reason for my high numbers and he said “Yes. Maybe” which didn’t really answer anything at all 😂

The conclusion he came to was “if it was anything nasty, we would have found it in your very full pool of immunoglobulins” I will feel comfortable when I know what it is that is causing my fatigue & PEM. I think the answer is in that pool of immunoglobulin because it’s busy doing something!

We are planning on kids within the next year or two so I’m naturally a bit nervous with this igg.

 

[Gingergrrl]

He is very expensive so I’m reluctant to go back unless I am diagnosed with something autoimmune which I can leave in the hands of my capable gp.

Would the immunologist be the one to test your ANA or other autoimmune panels or would your GP do that?

I do megadose iv vitamin c and antioxidants and I asked if this could be a reason for my high numbers and he said “Yes. Maybe” which didn’t really answer anything at all 😂

Did he mean that those are immunostimulatory or something different? I'm not sure if I understand his answer?

The conclusion he came to was “if it was anything nasty, we would have found it in your very full pool of immunoglobulins”

This is a long-shot but have you had known mold/mycotoxin exposure? Many doctors only think of viruses and bacteria vs. an immune reaction that was triggered by mycotoxins. It may not pertain at all to your case but just wanted to mention it b/c it played a big role in my own situation.

We are planning on kids within the next year or two so I’m naturally a bit nervous with this igg.

Can you ask your ob-gyn or a pre-natal specialist if having high IgG is dangerous in pregnancy? I know it would not tell you WHY your levels are elevated but I would hope they might be able to answer some of your other questions.

 

[Hd-x]

But my iGG1 & 2 were high

I also have high IGG2 - the lab said high IGG2 happens if there is:
1.) allergic Alleovitis
2.) bacterial antigens like haemophilus influenza, Pneumokoken
if any chronic bacterial infections are the problem, the lab said testing for MBL and Phagozytose activity would be recommended.