Just diagnosed with high NK cells, what do I do now?

mon_n_john

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Reply Just diagnosed with high NK cells, what do I do now? Posted on: Aug 7, 2011 at 4:41am
Dear Dr. Braverman:

First of all I want to thank you for providing a forum to answer our questions so that women like myself can go on to have healthy babies. Thank you!

I have 2 children and 4 confirmed miscarriages, all of which were early losses. My last miscarriage was in June 2011. My RE recently suggested that I get an immunilogical blood test as she suspected this was the reason for my RPL. I was tested for APA, ETF, and RIP. I was told that APA and ETF both came back normal but that my RIP was positive.

Apparently there was a marker on my NK cells cd56/16+ and I was told that my level was 20.6 which they said was high. My RE is currently on vacation and won't be back for 2 weeks. My biggest problem at the moment is that I might be pregnant again. While we were waiting for the results to come back my husband and I continued TTC (we were never told to stop) and with these results we are very worried that if I am pregnant I will have another miscarriage with treatment. I am currently 8 DPO and I tend to get pregnant very easily.

Now I think it's important that I clarify my pregnancy history briefly:
1. First son, conceived naturally & quickly. Only complication was 3rd trimester pre-eclampsia. I was induced at 38 weeks. He was born in 1995.
2. 2nd pregnancy was a chemical in Oct. 2002.
3. 3rd pregnancy was an early miscarriage at about 4.5 weeks in Dec. 2002.
4. 4th pregnancy I became pregnant immediately after my MC. My RE gave me progesterone since my levels were low (800 mg a day). I made it as far as 5.5 weeks but miscarried in Jan. 2003. My RE felt at the time that the progesterone was started too late to save the embryo.
5. 5th pregnancy I started taking the progesterone the same day I got my positive HPT. I continued to take them until my 13th week of pregnancy. Only complications during that pregnancy were a few episodes of premature labor (which I was put on bed rest) and again, pre-eclampsia, which led to me being induced at 36 weeks and turned into an emergency c-section. My son was born very healthy though and is my little miracle.
6. 6th pregnancy was a very early loss in June 2011. I miscarried a few days after my positive HPT.

The reason I clarified the above is because if NK cells are indeed the problem then I don't know how my last son made it without me receiving immunilogical treatment. Assuming I am pregnant now (which I think I am) is there any chance at saving this pregnancy without prior immune treatment? I can't wait for my own Dr. because she won't be back for another 2 weeks and it might be too late by then and I am very worried about these elevated NK cells in my blood.

Do you have any suggestions and/or reccomendations? Is there any treatment for high NK cells that can be done at this stage? (Basically right around the time a HPT would turn positive.) Again I was told my level was 20.6. Thank you SO much for taking time to read my post. If you need any more information please let me know.

Thanks again from the bottom of my heart,
Monica

Dr. Braverman

2017 Posts
Re: Just diagnosed with high NK cells, what do I do now? Posted on: Aug 9, 2011 at 12:49am
NK cells by them selves should never be used to make a diagnosis of immunologic rejection of a pregnancy. You really have to see all the immune cells, so one level of 20(which is not that elevated) does not give you basis for treatment. Your history however does dictate a very thorough workup.

It is not unusual for a first child (especially a boy) to make it to term then to suffer complications with all succeeding pregancies. this could be due to HY restricting alleles(genes in the mother that pick up male antigen from the baby and activate the immune system) or an underlying immune issue in the mother that was activated by the pregnancy.

I would ge happy to assist you in finding some answers. Feel free to call my office and schedule a consultation.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

mon_n_john

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Reply Re: Just diagnosed with high NK cells, what do I do now? Posted on: Aug 9, 2011 at 3:41pm
Thank you Dr. Braverman. I think I will call you and schedule a phone consultation (I live very far away from your office). Luckily I checked with my insurance and you are one of their approved doctors so thankfully you accept my insurance.

Would you be able to tell me when I would be able to expect a phone consultation with you?

Many, many thanks!
Monica

Dr. Braverman

2017 Posts
Re: Just diagnosed with high NK cells, what do I do now? Posted on: Aug 10, 2011 at 3:43am
Im not sure how the schedule is right now, but Im sure they will get you an appointment within a very reasonable time frame. look forward to speaking with you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Dr. Braverman

2017 Posts
Re: Just diagnosed with high NK cells, what do I do now? Posted on: Aug 12, 2011 at 4:44am
call me in my office tomorrow and I will help you sort this out. My staff has probably never heard of your insurance(as it is not a typical one we see here in NY) so maybe we can call them and get clarification. I would love to help you with your problem.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

mon_n_john

0 Posts
Reply Re: Just diagnosed with high NK cells, what do I do now? Posted on: Aug 12, 2011 at 3:24pm
Thank you Dr. Braverman. I really appreciate your help with this.

I just called your office and asked to speak to you directly but the receptionist just took my name and number. I figured that it would be better if I provided my number directly to you. You can reach me at 305-247-7082 at anytime.

Just so you know, I do have a copy of my entire medical file with my RE so I could easily send that to you right away. In addition, it seems I have had yet another chemical pregnancy. I got one very faint positive result on a home pregnancy this cycle so that brings my total losses to 5 so far.

Please call me when you get a chance. I would love to work with you if you can accept my insurance. If it helps, my RE has been able to bill everything to my insurance by using the "habitual aborter" diagnosis code.

Talk to you soon and thanks again,
Monica

Dr. Braverman

2017 Posts
Re: Just diagnosed with high NK cells, what do I do now? Posted on: Aug 12, 2011 at 5:34pm
Hope our call was helpful.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

mon_n_john

0 Posts
Reply Re: Just diagnosed with high NK cells, what do I do now? Posted on: Aug 13, 2011 at 3:28am
Thank you so much for taking the time to call me back today Dr. Braverman. I really appreciate it. I can't tell you how nice it is to encounter a doctor that genuinely cares.

I gave your office all my insurance details and someone is going to call my insurance company and verify the coverage information before I fly out to see you. Hopefully I'll get a call back on Monday confirming that everything is all set.

Thanks again and talk to you soon!
Monica