Intralipids question

Hedger

16 Posts
Reply Intralipids question Posted on: Nov 3, 2011 at 9:17pm
I done my immune testing with a clinic that only do the nk assay with Ivig - it was shown to reduce my nk cells. My new consultant would like me to get the nk assay re-done using intralipids. My question is is it really worth doing (time and cost)? Are there many cases where intralipids dont work? My thoughts were just start my treatment 'blindly' with intralipids - the consultant hasnt a problem with that and says it is my call

My original NKa results were

NK Assay (% killed) Panel
50:1 8.2 % (range 10-40) Low
25:1 5.6 % 5-30
12.5:1 2 % (range 3-20) Low
IgG conc 12.5 50:1 6.1 %
IgG conc 12.5 25:1 5.5 %
IgG conc 6.25 50:1 7.9 %
IgG 6.25 25:1 7.4 %
CD3% 85.3 % 60-85 H
CD19% 1 % 2-12 L
CD56% 11.6 % 2-12
CD19+, CD5+ Cells 22.2 % 5-10 H
Hashimoto's
rheumatoid arthritis
positive antithyroid antibodies.
Immune testing notable results =
very high Thyroid Antibodies >3000

mildly positive ANA speckled pattern

upper range CD3% 85.3% (60-85) and CD56% 11.6 (2-12) 
and very high CD19+
CD5+ cells 22.2% (2-12)

Dr. Braverman

2027 Posts
Re: Intralipids question Posted on: Nov 4, 2011 at 1:53am
your consultant as well as your first treating doctor probably dont understand immunology , if they are
1. Willing to treat you solely based on NK activiy
2. think there is any validity to the IVIG or IL test in the lab.

if you want to be serious about treatment get the correct testing then the correct treatment.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Hedger

16 Posts
Reply Re: Intralipids question Posted on: Nov 4, 2011 at 8:34am
That was only part of my testing. I have had numerous other tests (dqa cytokines karyotype LAD hidden C gene antibodies etc) My treatment plan will comprise of prednisolone, clexane, gestone, intralipids. I have also been diagnosed with hashimotos.

What other tests would you recommend?
Hashimoto's
rheumatoid arthritis
positive antithyroid antibodies.
Immune testing notable results =
very high Thyroid Antibodies >3000

mildly positive ANA speckled pattern

upper range CD3% 85.3% (60-85) and CD56% 11.6 (2-12) 
and very high CD19+
CD5+ cells 22.2% (2-12)

Dr. Braverman

2027 Posts
Re: Intralipids question Posted on: Nov 5, 2011 at 2:37am
what were the results of all your immune tests to date? Then I can better help you decide what else to order and of course what the treatment should be. I would also need a detailed history . You would be much better served by calling me and scheduling a consultation so we can go over your case in detail.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Hedger

16 Posts
Reply Re: Intralipids question Posted on: Nov 11, 2011 at 2:24pm
07-Sep-11 Result Units Ref Flag
TH1 : TH2 Cytokine Ratio
TNF-a : IL10 (CD3+CD4+) 21.1 13.2-30.6
IFN-g : IL10 (CD3+CD4+) 8 5.8-20.5
Histone antibodies Negative

Thyroid Antibodies
Thyroid peroxadase anibodies >3000 IU/ml 0-50 H
ANA Weakly positive - speckled & diffuse pattern
DNA Antibody (DS) Negative
Cardiolipin Ab IgG 6.8 U/ml 0-17
Cardiolipin Ab IgM 3.2 U/ml 0-15

NK Assay (% killed) Panel
50:1 8.2 % 10-40 L
25:1 5.6 % 5-30
12.5:1 2 % 3-20 L
IgG conc 12.5 50:1 6.1 %
IgG conc 12.5 25:1 5.5 %
IgG conc 6.25 50:1 7.9 %
IgG 6.25 25:1 7.4 %
CD3% 85.3 % 60-85 H
CD19% 1 % 2-12 L
CD56% 11.6 % 2-12
CD19+, CD5+ Cells 22.2 % 5-10 H

DQa both 3.1, 4.1
LAD
Flowcytometry negative
T cells IgM+ 1.5
T cells IgG+ 1.6
B cells IgM+ 40.0
B cells IgG+ 14.8

Hidden C negative
Mycoplasma ureaplasma negative
Laparoscopy and hysteroscopy last month - left ovary adhesion, seperated

Husband semen ok
Hashimoto's
rheumatoid arthritis
positive antithyroid antibodies.
Immune testing notable results =
very high Thyroid Antibodies >3000

mildly positive ANA speckled pattern

upper range CD3% 85.3% (60-85) and CD56% 11.6 (2-12) 
and very high CD19+
CD5+ cells 22.2% (2-12)

Dr. Braverman

2027 Posts
Re: Intralipids question Posted on: Nov 12, 2011 at 1:22pm
with only limited data (and I must be clear about that) I can not give an accurate recommendation . But from what I see I think you only need lovenox and prednisone, not intralipids . IVIG has also been shown to be useful here but for the expense you might do well with just the lovenox and prednisone.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Hedger

16 Posts
Reply Re: Intralipids question Posted on: Nov 14, 2011 at 11:54am
Would intralipids not help the cd19cd5?

What other tests would you like me to get? I thought i had covered all bases
Hashimoto's
rheumatoid arthritis
positive antithyroid antibodies.
Immune testing notable results =
very high Thyroid Antibodies >3000

mildly positive ANA speckled pattern

upper range CD3% 85.3% (60-85) and CD56% 11.6 (2-12) 
and very high CD19+
CD5+ cells 22.2% (2-12)

Dr. Braverman

2027 Posts
Re: Intralipids question Posted on: Nov 15, 2011 at 2:35am
no evidence at all the IL lower CD19/5, but the antibodies produced are treated by the lovenox and prednisone.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.