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Immuno Blood Work Back Since Starting Anti-Virals And Pneumo Vaccine

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My doctor's office called today to go over my labs. I had them fax a copy to me as well so I can compare.

The GOOD NEWS is that my body DID respond well to the pneumonia vaccine. The anti-viral is bringing my EBV titers down as well!

What is weird is my IgG subclasses. My subclass 1 went way down (below normal) and most of the others dropped as well but not below normal like subclass 1 did. Only subclass 2 went up slightly.

My IgG serum total went up some which is good but the doctor was hoping it would go down so we can do IVIG therapy as she feels this will help.

All of this is Greek to me. Does this make sense to anyone? I believe all of my subclasses were normal and only my total serum IgG's were on the low side 6 weeks ago. Is this good or bad?

Thanks for any insight.


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Very cool that your viral titers are coming back down. I know my immunologist was involved in a big study at Stanford and he was saying that of all their patients who were responders to anti-virals and had good outcomes with them, half of them didn't have their viral titers come down at all. Just thought that was an interesting point.

Don't really know what all the subclasses mean though. Sorry! Maybe AZ girl will have more insight?

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Well that is good to know Chaos! I am pretty excited about the EBV titers coming down. I do think I have a bit more energy but then again doing yard work for a short time this weekend kicked my butt so who knows. Just went for a nice walk with my hubby though and it felt great.

Another positive note is they started me on a new med for my GI issues which is just amazing! We are weaning me off the SNRI and hoping the flushing and vertigo with exercise gets better. The SNRI had my colon functioning somewhat so I was really scared to stop taking it but this new medication is the best thing that has happened to me in a while gut wise and I'm thrilled!

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Kris, if you'd like to read more about sub classes go to http://primaryimmune.org. There is alot of information about immune deficiency diseases. Your vaccine was done to see if your immune system is still functioning inspite of the low igg's. It was your total igg that was low not your iga and igm, right?

Since your responded to the vaccine it shows your system is working at some level. It may be possible that your viral load and infection was suppressing or over stressing you immune system and now that you are treating that and bringing down the load, it may be starting to work more normally again.

I see why you doc thinks it would be good for you. I'm on it and it has been helpful but it is not a cure and does not eliminate all dysfunction, you still need to treat other known illnesses in addition to ivig.

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Thanks arizona girl. Yes it was my total that was low to begin with. Now that has gone up but the subclasses all went down with the IgG 1 going below normal. The rest went down but are in the low normal range.

She is hoping to do the sub Q version of IVIG but my total IgG's have to drop into the 600's in order for insurance to cover it I guess. They went up to 790 with the vaccine so who knows what will happen now. I will have lots of questions for her when I see her on the 23rd.

Thanks for all the info!

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Your welcome, you need to know what the number is for the each of the Total quantitative immungobulins. There are three IGG, IGA, IGM. Are they all below normal or a combination of them below normal? It means different things depending on which ones are low. 790 sounds like the range for igg. It will be hard for her to get it approved as 790 is boarderline and you responded to your vaccine challenge.

IVIG btw is given thru a IV. Subq is also immunoglobulin and is given into the muscle. Subq you usually get weekly and are taught to give it to yourself. IVIG is given on a more monthly cycle and requires a nurse or infusion center to give it to you. I do ivig so I only have to deal with it once a month and I can't imagine being able to stick myself. Subq though keeps your totals more even throughout the month.

You are having an unusual response. However that could be due to your antivirals. Maybe you will be lucky and that will correct some of the things you've got going on. IVIG is good if you need it, but not something you'd want to do if you don't need it.

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Here are my totals:

IgM 151

IgA 212

IgG 790

IgE 1.5

IgG Subclass 1 358

IgG Subclass 2 322

IgG Subclass 3 50

IgG Subclass 4 7.4

Immunoglobulin G Serum 762

Yes I know that IVIG is done through IV and that what she wants to do is subquetaneously. She said that she doesn't like to put her immunodeficient patients in a hospital type setting where we can possibly run the risk of getting sick so she prefers to use Hizentra which is the sub q version. She had me watch a video about it. My total IgGs went up so it doesn't look like I will eligible which is good on one hand but not good on the other. She said that I will feel SOOOO much better on Hizentra. At the same time, I don't like the idea of putting other people's blood product into my body. If my body can heal itself with the help of anti-virals and we can get things under control that would be great!

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Kris- Did you have a "natural killer cell function" test done?

I know my immunologist has said he's hoping that by decreasing the viral load with anti-virals that my immune system will start kicking in more. I'm kind of like you in that I have 1 subclass that's low and another that's low normal. He's just watching at this point to see if they'll improve with the anti-virals as he doesn't want to risk IVIG unless all 4 subclasses are low.

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Could be. Natural Killer cells are what apparently patrol and take out viruses and cells that are mutating (i.e becoming cancerous etc), so it would make sense that those of us who seem to be running high viral loads have low NK cell function. Actually we don't necessarily have a low number of NK cells themselves, but it's that their "function" is impaired. (Hence why you need the NK cell FUNCTION test and not just a count of NK cells.) Seems to be a very common finding in ME/CFS patients, especially those with a post-viral onset.

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