FULL TESTING - A FEW RED FLAGS

Sue Harteloh

4 Posts
Reply Posted on: Jun 25, 2012 at 11:01pm
Dear Dr B - Hoping you can assist.

Had full immune testing done. Would appreciate your opinion:

Partial DQa match = 4.1*
(plus 1 HLA-C match & 1 HLA-DRB1 match, no other matches)*
(1 son with husband 12 years ago, no pregnancies since)

NK ASSAY:
50:1 = 11.3
25:1 = 8.1
12.5:1 = 4.7

TH1/TH2 RATIO:
TNFa:IL-10 = 12.4
IFNg:IL-10 = 6.3

IMMUNOGLOBULIN PANEL:
IgG = 964
IgM = 180
IgA = 201

RIP:
CD3 = 86.5 (high)*
CD4 = 69.1 (high)*
CD8 = 14.7 (low)*
CD19 = 10.6
%CD3/CD56 (NKT) = 2.7
CD56, CD16 = 2.6
CD56 = 2.3
CD3/IL-2R = 1.9
%CD19, CD5 = 5.7

ANA, APA, Anti-DNA, ATA = (full testing) all normal

CRP, RF, HIV, HEP C, HEP B, THYROID PANEL, CDC w Diff = all normal

*The RED FLAGS are the 4.1 partial DQa match (plus 2 other HLA matches) and the 3 abnormal RIP values (CD3, CD4, CD8).

QUESTIONS:
1. Can the abnormal RIP alone cause infertility (I've been unable to get pregnant with high grade donor embryos)?
2. What could possibly be the cause of the high CD3 & CD4, low CD8 - especially since my other results are "normal"?
3. Assuming these are my ONLY abnormal results (still waiting on MTHFR, Prothrombin, LAC results), would you treat the abnormal RIP? If so, with what (IVIG, IL, steroids)?

Thank you so much for your help. Your opinion is greatly valued.

PS - if I turn to you for treatment, what additional tests beyond the above would I need to have run? Would they be helpful in my case?

Dr. Braverman

2024 Posts
RE: FULL TESTING - A FEW RED FLAGS Posted on: Jun 26, 2012 at 5:37am
Hi , I am very sorry for your losses. I dont think you have any issues with the RIP in fact most of the critical cells are low not high , including your cytokine ratios. Who has recommended treatment for this? The CD3,CD4, are not values alone that help identify a problem with immune rejection .

I beleive that in this case suppression may only make things worse not better, and the 3 HLA matches I feel are of no concern as well.

As always I must state I do not know your complete history so final conclusions on treatment must reside with your treating physician.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.