NK (Natural Killer) cell count

[SgtGerryBoyle]

Recently I've had a battery of tests done at IMD Labor in Berlin, mainly with the purpose of doing an antibody-neutralisation test for Coxsackie virus B3, B4 and B5 as @Hip recommends.

Among the results were a positive Coxsackie B4 test with low titers (1:20) but also a very low NK cell count. My NK cell count came back at 107/µl where the normal range is set from 210-740/µl.

What could this indicate and has anyone else here have NK cell count testing done (and what were the results)?

 

[Tammy]

My NK cells were extremely low..............I no longer have the test results so I can't give you a number..............I just remember being shocked at how low the number was. The immunologist that i saw at the time said it was because of the EBV that he diagnosed me with. Said it was the root cause of all my symptoms. He said my lab test results were just as bad as some of his AIDS patients.

 

[Markus83]

NK cell count fluctuates over the day and between days, so you might get higher values next time. Besides that, 107 /ul is not so low; it's more that IMD has a bit special reference ranges. I have seen labs where the ref range for NK cells starts at 80 /ul. Can you give all cell counts that where measured?

Edit: How long did the blood take to come to the lab? For cell count analysis it has to be in the lab in no longer than 24 hrs.

 

[SgtGerryBoyle]

Thank you so much for your replies.

@Markus83 the blood was collected at the lab itself in Berlin, not sure how long they kept it before performing analysis on it.

I'm attaching photos of the values below, saves me a lot of typing

 

[Hip]

Among the results were a positive Coxsackie B4 test with low titers (1:20) but also a very low NK cell count. My NK cell count came back at 107/µl where the normal range is set from 210-740/µl.

Generally low titers is nothing to be concerned about: ME/CFS doctors look for chronically high antibodies as evidence for ongoing infection.

Usually in ME/CFS it is the NK functioning/activation which is low, rather than the NK number. Not sure what low numbers means.

 

[bread.]

what do we know about chronic low cd8 cells? is this smthg happening in me/cfs?

 

[Markus83]

As I said the NK cells are not so low in my eyes. More important than absolute numbers is the function of the NK cells (you can test it: NK-Zytotoxiztätstest). I would recommend to do this test.

I would also look whats going on with the eosinophiles. Are you allergic? Did you have IgE measured? High eosinophiles can be caused by allergic reactions like asthma or parasitic infections.

 

[SgtGerryBoyle]

@Hip thank you for your reply, given the results it seems I don't have to be worried about an active enterovirus infection, what's your take on the 1:20 CVB4?

Edit: sorry, I see you said low titers is not something to be concerned about. I was just so triggered by the description on your Chronic Sore Throat site which I match exactly.


@Markus83 thank you, I had not really looked at the eosinophiles. I have been tested on a quite a few parasites
Giardia/Cryptosporidium/Entamoeba - all negative.

My primary focus has been on a CVB4 infection since I have all the symptoms listed on @Hip's Chronic Sore Throat site - including the crêpe paper-like wrinkling of the skin.

Edit: the only thing standing out in previous blood tests is that my IgG EBV titers are off the charts - literally

 

[Hip]

@Hip thank you for your reply, given the results it seems I don't have to be worried about an active enterovirus infection, what's your take on the 1:20 CVB4?

It does not seem like you have active CVB4. On the ARUP lab tests, Dr Chia says titers of 1:160 and high indicate active infection.

I know one person on this forum who tested at IMD, and had CVB5 at 1:320, which is high, and suggests active infection. But your CVB4 titer of 1:20 looks low.



You still could have active enterovirus infection, though. The two most common enteroviruses in ME/CFS are CVB3 and CVB4 according to Dr Chia. You have tested for these, so have covered the most common enteroviruses.

But you have not been tested for CVB5 and CVB1. So you could have those (CVB6 is very rare, and almost never seen, so you don't have to worry about this one). You could also have an echovirus infection, which is a similar sort of enterovirus to coxsackievirus B.

Dr Chia uses the ARUP lab tests, which cover CVB1 to CVB6, and echovirus 6, 7, 9, 11 and 30.



The trouble with enterovirus testing is that there are very few labs in the world which offer the required antibody neutralization test, the sensitive type of antibody test that Dr Chia uses. Though @Markus83 just a moment ago seems to have found another German lab which offer a neutralization test for CVB1 to CVB6 — the full range of 6 Coxsackie Bs — which is very interesting. See this post.

There is also a coxsackievirus B antibody neutralization test available at the Hellenic Pasteur Institute in Greece for €68. This covers CVB1 to 6.

 

[SgtGerryBoyle]

There's a medical condition of idiopathic CD4 lymphocytopenia (ICL), which is diagnosed when a person has a CD4 count of less than 300 cells per mm3 of blood, in the absence of any HIV virus.

@Hip I see you mentioning a low CD4 count in absence of HIV - was this in response to my lab results? The CD4 count in my results seems to be in normal range?

 

[Hip]

I see you mentioning a low CD4 count in absence of HIV - was this in response to my lab results?

You mentioned above that you had very low NK cell count, in your first post, and I was responding to that.

 

[Markus83]

You mentioned above that you had very low NK cell count, in your first post, and I was responding to that.

CD4+ are T-helper cells - different to NK cells which are CD56+

 

[Hip]

CD4+ are T-helper cells - different to NK cells which are CD56+

Whoops!

Sorry, I am pretty tired today, so with my brain fog, somehow muddled these two up.

I will delete my above text about CD4, as it is not relevant.

Thanks for pointing that out.

 

[heapsreal]

what do we know about chronic low cd8 cells? is this smthg happening in me/cfs?

Aussies studying cfs here in one of their nk function study's i believe the did a cd8 function study also and it was a common finding for cd8 function to be low in cfsers

 

[Tammy]

Edit: the only thing standing out in previous blood tests is that my IgG EBV titers are off the charts - literally

Have you ever considered that EBV would be playing a part?

 

[Seven7]

Usually in ME/CFS it is the NK functioning/activation which is low, rather than the NK number. Not sure what low numbers means.

It can be both, just not as common (I know of other patient in same boat), Which I agree is more common to just have the Low activity and normal Count.
FYI I had (or have haven't tested this year) low NK numbers as well as function, It is officially called Natural Killer cell dysfunction and the known treatment is antivirals if titters are high. This is good since insurance covers it and doctors (immunologist) understand it.
I tried it all treatment wise, and finally the I found something to raise it (since I could not tolerate the immunovir).

 

[godlovesatrier]

This is very common, Cort has a NK cell article on health rising. I'm not sure what they are currently but after my oxymatrine treatment my NK cells were quite low. I am currently taking siberian ginseng regularly, however my immune system is still struggling a bit. It's odd.

 

[SgtGerryBoyle]

This is very common, Cort has a NK cell article on health rising. I'm not sure what they are currently but after my oxymatrine treatment my NK cells were quite low. I am currently taking siberian ginseng regularly, however my immune system is still struggling a bit. It's odd.

Hi @godlovesatrier thanks for your response. If I understand correctly you suspect your NK cell count dropped due to the oxymatrine treatment?

I have been on oxymatrine myself for quite some time so if oxymatrine drops NK cell count my count might be a result, not a cause.

 

[SgtGerryBoyle]

It can be both, just not as common (I know of other patient in same boat), Which I agree is more common to just have the Low activity and normal Count.
FYI I had (or have haven't tested this year) low NK numbers as well as function, It is officially called Natural Killer cell dysfunction and the known treatment is antivirals if titters are high. This is good since insurance covers it and doctors (immunologist) understand it.
I tried it all treatment wise, and finally the I found something to raise it (since I could not tolerate the immunovir).

@Seven7 Thank you for sharing your insights. Would you mind sharing what did finally raise your NK cell count and activity?

 

[godlovesatrier]

That's right. I had blood work done the week after I stopped oxymatrine as I had the worst crash I've ever experienced. It lasted about 3 months. My crashes do normally last this long I have to say. At any rate yes it was just outside the normal range but my doctor didn't even mention it I only noticed awhile later.