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Immune deficiencies?


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I am wondering what exactly is an immune deficiency. We just got some recent results back, and one daughter is low in IGG and IGA- she is below the lowest number in the reference range the lab gave.

 

Does anyone know how to interpret this- haven't seen doc yet.....

 

Could prednisone cause this, and it be temporary?

 

Thx

 

Eileen

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I think it is considered significant if it is 2 standard deviations below the mean. Obviously, different doctors may have differing opinions- but I think I read this on the website for PID or and IVIg website. So-- break out your high school math? YIKES!!

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Eileen have you visited the Primary Immune Deficiency's website or the Jeffrey Model site? Lots of good info at both.

 

www.primaryimmune.org Click on the publications link & then the Patient & Family Handbook link. Chapters 1, 2 & 4 are a good place to start.

 

http://jmfworld.com/

 

Low IgG means that her body is not making enough immunoglobulins to fight off infections. Low IgA's is not as significant as the low IgG's. A good Immunologist will look at the number & type of infections along with the numbers to decide if the patient should receive IVIG. Some patients with borderline IgG numbers have multiple serious infections and greatly improve with tx. Some patients have very low IgG's but no history of recurrent serious infections only require frequent monitoring.

 

Did they test her 4 IgG subclasses? Sometimes you can have a normal overall IgG total but be extremely low in one of the four subclasses. Being extremely low in one of the subclasses is often enough for a PIDD dx & tx.

 

People with Immune Deficiency also tend to be more prone to autoimmune illnesses and abx resistant infections.

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I wonder this a lot for our PITANDS kids and worry about the use of steroids and high dose IVIG prior to getting all the infections. I have read that high dose long term steroids can reduce serum IGG levels. I tried to include the link in my post but couldn't get it to work but if you are interested I had just done a quick search: do steroids lower serum IGG's

 

Kim

Edited by momofgirls
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I am wondering what exactly is an immune deficiency. We just got some recent results back, and one daughter is low in IGG and IGA- she is below the lowest number in the reference range the lab gave.

 

Does anyone know how to interpret this- haven't seen doc yet.....

 

Could prednisone cause this, and it be temporary?

 

Thx

 

Eileen

 

Hi Eileen - I think that your child's clinical picture is as important as the IGG and IGA numbers. If your daughter is having frequent infections and has mildly deficient numbers, then you may want to pursue further specific testing of IGG subclasses, s pneumoniae titers (14 titers), and IGA subclasses to see if the problem is concentrated in one type of IgG or one type of IGA.

 

 

IVIG does replace IgG, but it does not replace IgA. In fact, if your daughter is very low in IgA she may need to be careful about the brand if IVIG she receives. From what I have learned, there is really no cure for low IgA, which stinks because IgA is the body's first defense against mucosal infections including sinus infections. IgG makes antibodies that fight the bacteria or virus once it is int the body.

 

Different insurance companies have different criterea for IVIG - if that is an avenue you are considering.

Edited by kimballot
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Eileen,

 

With the possibility of immune deficiencies in the picture, I would highly recommend that you see an immunologist who totally understands ID AND PANDAS (like Dr. B.) There are plenty of good immunologists out there, but the don't understand the clinical significance to our children. The reason I'm saying this is because I suggested to one of my clients (who's 3 daughters I suspect of having PANDAS/PITANDs...one is now officially diagnosed by her pediatrician) to call a local immunologist (she picked one at a good local children's hospital with a good reputation for their immunology department.) The response was that there was nothing wrong immunologically with her 3 children, even though they are constantly getting sick, diagosed with Autism, etc. In fact, she told me what the immunologist said, and it did include the fact that he felt something was going on, but couldn't find anything (I thought his honesty was good.)

 

Most immunologists do NOT understand the clinical significance of high CD3, low strep pneum titers, etc. In fact, I have had several doctors mention that they can't imagine insurance paying when the child has low strep pneum titers, and were blown away when they found out that ours very much does, and has a policy to that effect (you have to read your policy benefits, and make sure that you cover all bases.) Because they don't understand that, they tell you that there's nothing wrong with your child.

 

When you get a PANDAS knowledgeable immunologist, you are able to get the whole picture.

 

I think it's very important to consider that.

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