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Can you all tell me how many serotypes you should respond to from the

prevnar vaccine to be considered normal and abnormal. My son had 4

responses out of the 12 serotypes tested, his immunologist at home said

he has a antibody deficiency. We are at Cincinnati CHildren's having a

workup for his multiple issues(severe osteoporosis, GI problems, severe

worsening asthma, sinus polyps), the immunologist here said they

consider any response to vaccines normal. Even just 1 serotype

response. They said 1 response only they may want more testing, but 2

or more responses is normal. Our immunologist at home said they want 6

at least(which they consider borderline function) and anything less is

a deficiency. This immunologist here in Cincy is saying he could have

cystic fibrosis, and wants tests to that, which the drs at home do not

think is likely. All is differing opinions is crazy!! Would appreciate

knowing what you all have been told is the number of responses you need

to have adequate vaccine response. Also is pneumovax better than

prevnar? Thanks.

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,

We used to go to Cinci children's back when Dr. Lochelt was there and my kids

had response to 3 and he said they had a deficiency. They like to test for CF

there as we went through that there too. We didn't get our last 2 sets of

vaccine response back because both times they lost the kids blood! Both kids,

both times! Anyway, I think you get alot of variance depending on who you see.

I am not sure what the standard is for response to be considered normal. It

also depends on if they maintain the antibodies or not.

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smoot732000 wrote:

This immunologist here in Cincy is saying he could have

> cystic fibrosis, and wants tests to that,

, I have no idea what the answer to your question is about how much

is enough response. But, I want to assure you that most of our kids

have been tested for CF just to rule it out. So don't let that one

throw you.

I've found that you can get different answers from different doctors in

the same teaching hospital -- so, wait and see what all this one has to

say, then if it doesn't sound right -- ask IDF or this group for a

recommendation to another immunologist to check it out until you feel

secure with the answer. Since there is not a standard of care yet, you

get a wide variation depending on everyone's pet theory. Trouble is --

that pet theory can hurt a kid's chances for a normal life. But, I

would suggest that you let them check things out thoroughly before

deciding to go elsewhere. Some of my early changing doctors turned out

to be unnecessary. They were right in the first place!!! (At least one

of them was anyway!) I just had to get to the point of being willing to

hear what I didn't want to hear.

Hope that helps and best wishes for a " real " diagnosis soon.

In His service,

Dale

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and Dale,

Thank you both for your responses. I guess it does vary dr to dr.

After I posted this question I looked up on the american academy of

allergy asthma & immunology website and found a section on practice

parameters for immunodeficiency, and found it said they consider a

protective antibody response in a child 2-5 to be 50% of the

serotypes tested, and for ages 5 and older a protective response is

70% of the serotypes tested. So from their parameters it would appear

that our immunologist at home is more in line with what the

recomendations of the national physicans associations are. We love

our immunologist at home. He has gone way beyond what the average dr

would do. He is just at a loss with my daughter who has the systemic

eosinophilic disease. That is why he has sent us here. Our son has

symptoms so he wanted him evaluated also. Unfortunately, Cincinnati

is now at a loss too, as they admit they have not had a case like

hers, although they do treat many patinets with eosinophilic disease.

So anyway, we are in good hands at home, and will rely on him for

treatment. Even though he sends us to these top drs, he is well known

himself, and not afraid to disagree with these drs in Cincy if he

thinks they are wrong about something.

Dale I just wanted to let you know I love the way you sign as you are

in " His " service.

Thanks again

> This immunologist here in Cincy is saying he could have

> > cystic fibrosis, and wants tests to that,

>

> , I have no idea what the answer to your question is about how

much

> is enough response. But, I want to assure you that most of our

kids

> have been tested for CF just to rule it out. So don't let that one

> throw you.

>

> I've found that you can get different answers from different

doctors in

> the same teaching hospital -- so, wait and see what all this one

has to

> say, then if it doesn't sound right -- ask IDF or this group for a

> recommendation to another immunologist to check it out until you

feel

> secure with the answer. Since there is not a standard of care yet,

you

> get a wide variation depending on everyone's pet theory. Trouble

is --

> that pet theory can hurt a kid's chances for a normal life. But, I

> would suggest that you let them check things out thoroughly before

> deciding to go elsewhere. Some of my early changing doctors turned

out

> to be unnecessary. They were right in the first place!!! (At

least one

> of them was anyway!) I just had to get to the point of being

willing to

> hear what I didn't want to hear.

>

> Hope that helps and best wishes for a " real " diagnosis soon.

>

> In His service,

> Dale

>

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> > This immunologist here in Cincy is saying he could have

> > > cystic fibrosis, and wants tests to that,

> >

> > , I have no idea what the answer to your question is about

how

> much

> > is enough response. But, I want to assure you that most of our

> kids

> > have been tested for CF just to rule it out. So don't let that

one

> > throw you.

> >

> > I've found that you can get different answers from different

> doctors in

> > the same teaching hospital -- so, wait and see what all this one

> has to

> > say, then if it doesn't sound right -- ask IDF or this group for a

> > recommendation to another immunologist to check it out until you

> feel

> > secure with the answer. Since there is not a standard of care

yet,

> you

> > get a wide variation depending on everyone's pet theory. Trouble

> is --

> > that pet theory can hurt a kid's chances for a normal life. But,

I

> > would suggest that you let them check things out thoroughly

before

> > deciding to go elsewhere. Some of my early changing doctors

turned

> out

> > to be unnecessary. They were right in the first place!!! (At

> least one

> > of them was anyway!) I just had to get to the point of being

> willing to

> > hear what I didn't want to hear.

> >

> > Hope that helps and best wishes for a " real " diagnosis soon.

> >

> > In His service,

> > Dale

> >

>

>

>

>

>

>

>

> This forum is open to parents and caregivers of children diagnosed

with

> a Primary Immune Deficiency. Opinions or medical advice stated

here are

> the sole responsibility of the poster and should not be taken as

> professional advice.

>

> To unsubscribe -unsubscribegroups (DOT)

> To search group archives go to:

> /messages

>

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,

Thanks for letting me know your experience with the immunologists

here. I would love to e-mail you later as well. We are here in Ohio

still and have more tests Monday, so we are about to leave for a

little weekend getaway until we have to go back to the hospital. If

it is OK I will e-mail you early next week. Thanks again, It seems

the opinion here is way off base for immune deficencies. They are so

well known, and do have much experience with rare diseases, so it

throws me off to hear them say this. Glad to know we were not the

only ones. Take care.

> > This immunologist here in Cincy is saying he could have

> > > cystic fibrosis, and wants tests to that,

> >

> > , I have no idea what the answer to your question is about

how

> much

> > is enough response. But, I want to assure you that most of our

> kids

> > have been tested for CF just to rule it out. So don't let that

one

> > throw you.

> >

> > I've found that you can get different answers from different

> doctors in

> > the same teaching hospital -- so, wait and see what all this one

> has to

> > say, then if it doesn't sound right -- ask IDF or this group for a

> > recommendation to another immunologist to check it out until you

> feel

> > secure with the answer. Since there is not a standard of care

yet,

> you

> > get a wide variation depending on everyone's pet theory. Trouble

> is --

> > that pet theory can hurt a kid's chances for a normal life. But,

I

> > would suggest that you let them check things out thoroughly

before

> > deciding to go elsewhere. Some of my early changing doctors

turned

> out

> > to be unnecessary. They were right in the first place!!! (At

> least one

> > of them was anyway!) I just had to get to the point of being

> willing to

> > hear what I didn't want to hear.

> >

> > Hope that helps and best wishes for a " real " diagnosis soon.

> >

> > In His service,

> > Dale

> >

>

>

>

>

>

>

>

> This forum is open to parents and caregivers of children diagnosed

with

> a Primary Immune Deficiency. Opinions or medical advice stated

here are

> the sole responsibility of the poster and should not be taken as

> professional advice.

>

> To unsubscribe -unsubscribegroups (DOT)

> To search group archives go to:

> /messages

>

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In a message dated 1/6/2006 4:26:29 PM Pacific Standard Time,

smoot732000@... writes:

Would appreciate

knowing what you all have been told is the number of responses you need

to have adequate vaccine response. Also is pneumovax better than

prevnar? Thanks.

_________________________________________________________________________

Hi ,

My son only responded to two at an adequate level. Our Immunologist also

went by 's clinical picture which was not good at the time. He had

chronic ear, sinus and strep infections. At least one or two of these in

combination about every two to three weeks.

He is now being treated with IVIG and his quality of life has improved

dramatically. He still gets sinus infections--but not very often. The strep

and

ear infections are gone.

Hang in there!!

Sandi, mom to , age 12, CVID

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