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-

you may want to check out a website called Understanding Your Tests-

I've used it to help to understand my daughters labs results-

the web site address is www.labtestsonline.org/understanding/index.html

Sue Petrelli

Mom to 14 yr old CVIDer

jmfritze <jmfritze@...> wrote:

Ok, so I finally got a copy of Ana's lab results and I was wondering

if I post the numbers here if you guys can give me your

Ana 14 mo

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Primary Immune Deficiency. Opinions or medical advice stated here are the sole

responsibility of the poster and should not be taken as professional advice.

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Let me tell you what happened with . We would run the tests and

he would be borderline low and run it again in 30 days and he would be

normal. I think that with the infection in full force you won't get an

accurate reading but then again that is just my opinion.

Cassie

jmfritze wrote:

> Ok, so I finally got a copy of Ana's lab results and I was wondering

> if I post the numbers here if you guys can give me your opinions. I

> am wondering if they look right to you, by right I mean normal

> enough to call her " cured " and not even look at her for six months.

> Also, the immunization responses don't give ranges, so I am

> wondering how I know if they were interpreted correctly. And there

> is some stuff that is high (in her t-cell counts) that I dont' know

> if it is a big deal or not. Thanks!

>

> Platelet 634 (150-450) (always high, still never have gotten an

> explanation)

> MPV 5.9 (7.4-10.4)

>

> IgG sub 1 297 (286-680)

> IgG sub 2 38 (30-327)

> IgG sub 3 27 (13-82)

> IgG sub 4 0 (1-65)

> IgG 363 (331-1165)

> IgE <4.5 (0-60)

>

> CD3+ T-CELLS 62% (74-74)

> CD4+/CD3+ HELPER 41 (39-49)

> CD8+/CD3+ SUPPRESSOR 14 (17-31)

> CD19+ (BCELLS) 26 (16-28)

> CD16+56+/CD3-NK CELLS 10 (3-9)

> CD3+ ABSOLUTE 6422 (1100-5000)

> CD4+/CD3+ ABSOLUTE 4254 (800-3000)

> CD8+/CD3- ABSOLUTE 1486 (500-2700)

> CD19+ ABSOLUTE 2680 (500-1800)

> CD16+56+/CD3- 1065 (100-500)

> CD4:CD8 RATIO 2.86 (.5-2.7)

>

> Mumps status negative

> rubella IgG positive

> Rubeola status positive

> diphtheria 1.69

> Tetanus .72

>

> There is also this list of things (phytohemagglutinin levels 1-4,

> pokeweed level 1-4, concanavalin A level 1-4) which I have no clue

> as to what they are.

>

> As a reference, when the blood was drawn Ana was on day 18 of a 20

> run of ceftin for ear infection. On that day the doctor said the

> infection and fluid were gone but the eardrums still looked " sucked

> in " on both sides. Her WBC was slightly elevated.

>

> If you have read this far you're wonderful...thanks for any input

> you can give! I am way to naive at this stuff.

>

>

> Ana 14 mo

>

>

>

>

>

> 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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Immune studies are so difficult to read but many of the parents here may be

able to help. Give them a chance to chime in...

Here are a couple things to clarify:

1. Is MPV mean platelet volume? If so, this may need to be evaluated. I

don't know whether or not the is related to immune status and/or infection. How

are her other blood indicators such as hemaglobin? Ferritin or iron status?

MPV 5.9 (7.4-10.4)

What is going on with her albumin? I thought you said it was low at one

point.

2. From what you post, it appears like she is borderline or low with some

subclasses. These may naturally increase with age -- but I don't know about

this with FTT and all of her long courses of antibiotics for infections.

IgG sub 1 297 (286-680)

IgG sub 2 38 (30-327)

IgG sub 3 27 (13-82)

IgG sub 4 0 (1-65)

Children's Hospital Los Angeles' " Normal " is > 400 for total IgG. I think

that standard deviations from the " average " is what matters, though. And,

obviously, the clinical picture as well. Every hospital has slightly different

ranges of " normal " .

IgG 363 (331-1165)

3. With IgE this low, you can not test for allergies. A high IgE is

indicative of allergies, parasitic infections, among other things. Scientists

still do not know what to make of low IgEs -- it does not mean " great " it means

" we just don't know " . But, we do know that with IgE this low you absolutely

will not get accurate IgE based (e.g., RAST) allergy tests.

IgE <4.5 (0-60)

4. ???? Sorry. You really need an immuno that will sit down with you are

explain this stuff. Looks like a couple subsets are low or borderline. I don't

think it is logical to ignore the low numbers here.

CD3+ T-CELLS 62% (74-74)

CD4+/CD3+ HELPER 41 (39-49)

CD8+/CD3+ SUPPRESSOR 14 (17-31)

CD19+ (BCELLS) 26 (16-28)

CD16+56+/CD3-NK CELLS 10 (3-9)

CD3+ ABSOLUTE 6422 (1100-5000)

CD4+/CD3+ ABSOLUTE 4254 (800-3000)

CD8+/CD3- ABSOLUTE 1486 (500-2700)

CD19+ ABSOLUTE 2680 (500-1800)

CD16+56+/CD3- 1065 (100-500)

5. This one looks odd to me. Ask the group what this ratio means. I don't

want to confuse you but I think that this high of a ratio may be indicative of

something.

CD4:CD8 RATIO 2.86 (.5-2.7)

6. Was the titer to mumps negative?

Mumps status negative

rubella IgG positive

Rubeola status positive

7. I am not sure about these.

diphtheria 1.69

Tetanus .72

8. " There is also this list of things (phytohemagglutinin levels 1-4, pokeweed

level 1-4, concanavalin A level 1-4) which I have no clue as to what they are. "

This is mitogen response or T-cell response " stuff " in the environment. There

should also be antigen (protein or organisms) response -- another type of T-cell

response to things that you are suppose to develop antibodies to. Were antigen

studies run or just mitogen?

9. " the blood was drawn Ana was on day 18 of a 20 run of ceftin for ear

infection. On that day the doctor said the

infection and fluid were gone but the eardrums still looked " sucked in " on both

sides. " You have some clinical issues going on. Log everything.

10. " Her WBC was slightly elevated " -- which could very well mean that the

IgG levels were high for Ana.

11. *****Where is her IgM level?********

" If you have read this far you're wonderful...thanks for any input you can

give! "

I would call IDF, lung line (Dr. Gelfand's people), and consider another eval.

We are still here for you. <smile>

mom CVIDer

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 the input....

> 1. Is MPV mean platelet volume? If so, this may need to be

evaluated. I don't know whether or not the is related to immune

status and/or infection. How are her other blood indicators such as

hemaglobin? Ferritin or iron status?

>

>---Yes this is mean platelet volume. I have never understood why

this is low and the count is high but it always is. What kind of

doctor could explain this to me? Her hemaglobin is always fine, I

don't see her ferritin or iron on any of her bloodwork.

> What is going on with her albumin? I thought you said it was

low at one point.

----------Her albumin has been up and down, with the latest blood

work it was normal.

>

> 2. From what you post, it appears like she is borderline or low

with some subclasses.

------Ok, can subclasses go up with infection? If she is healthy

would they go back down? And would my increased nursing raise them?

>

I don't think it is logical to ignore the low numbers here.

>

---This is what they want to recheck in six months..

This one looks odd to me. Ask the group what this ratio means. I

don't want to confuse you but I think that this high of a ratio may

be indicative of something.

> CD4:CD8 RATIO 2.86 (.5-2.7)

-------I have yet to find what this ratio means, but it is

consistently high.

>

> 6. Was the titer to mumps negative?

>-------Yes it was negative, is it normal for some to respond and

some not to?

>

> 8. " There is also this list of things (phytohemagglutinin levels

1-4, pokeweed level 1-4, concanavalin A level 1-4) which I have no

clue as to what they are. "

>

> This is mitogen response or T-cell response " stuff " in the

environment. There should also be antigen (protein or organisms)

response -- another type of T-cell response to things that you are

suppose to develop antibodies to. Were antigen studies run or just

mitogen?

---------I think just the mitogen, at least I don't see anything

else. How do I know if the numbers are within normal ranges??

>

11. *****Where is her IgM level?********

>------This doc doesn't recheck her IgM or IgA, she says if Ana had

them, which she did twice when they checked them, and they were in

the normal range, they will stay there, so she doesn't recheck them,

though I thought I asked her to.

>

> I would call IDF, lung line (Dr. Gelfand's people), and consider

another eval.

-------I think I will get a second opinion. But I don't know where

to go, maybe I will call Dr. Shapiro's office here in the cities.

But I have heard he is very busy, I'm afraid it will take months to

get her in, but I suppose that will happen anywhere we go. But I

get so hopeful because she hasn't had an infection in two weeks and

she has gained another few ounces I think. Maybe if I just wait

they will prove to be right? But I don't want to waste time waiting

if she is not ok.

>

> We are still here for you. <smile>

> --------Thanks so much. I'm so confused. But you are wonderful!

> Ana 14 mo

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How high are her platelets? 's get as high as 506,000 and no one is

ever concerned (Hematologist/blood doctor or the ped) They don't become

concerned until they get a lot higher. The normal range for children is

150,000-400,000. Labs often use a lower limit for the normal range, when in

reality 400,000 -450,000 is the upper limit for children

(Diagnostics-Springhouse 1998 & 2001 editions say 400,000 see also:

http://www.fpnotebook.com/HEM111.htm this site lists 450,000 as the upper

limit) Platelets can be elevated due to inflammation, infection and iron

deficiency anemia to name a few things. When looking at anemia, several

things need to be considered (all the RBC indices MCV, MCHC, MCH,

hematocrit, hemoglobin and total RBC), they also look at the RDW -- just

noting this so in case you worry about anemia. If you go to the

Shwachman-Diamond America page www.shwachmandiamondamerica.org

<http://www.shwachmandiamondamerica.org/> we have a blood forum on our

community message board. We've got links to several things there. Used to

have more-but a hacker destroyed it! SIGH.. It is getting back to normal

now.

My boys have their iron stores checked when they have their bone marrow

biopsies-and they don't have any stainable iron stores. This is expected

with their disease.

Mean Platelet Volume (MPV) is a measurement of the average size of platelets

<http://en.wikipedia.org/wiki/Platelets> found in blood and is typically

included in blood tests. Since the average platelet size is larger when the

body is producing increased numbers of platelets, MPV test results can be

used to make inferences about platelet production in bone marrow. We have

more links to MPV on the message board.

Peace Be With You,

Pattie

Don't let your past dictate who you are now, but let it be a part of who you

will become.

_____

Thanks for the input....

> 1. Is MPV mean platelet volume? If so, this may need to be

evaluated. I don't know whether or not the is related to immune

status and/or infection. How are her other blood indicators such as

hemaglobin? Ferritin or iron status?

>

>---Yes this is mean platelet volume. I have never understood why

this is low and the count is high but it always is. What kind of

doctor could explain this to me? Her hemaglobin is always fine, I

don't see her ferritin or iron on any of her bloodwork.

_____

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> How high are her platelets?

They range from 550-700 usually, with low platelet volume. It

confuses me. Thanks for the links, I will check it out.

Ana 14 mo

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-------I think I will get a second opinion. But I don't know where

to go, maybe I will call Dr. Shapiro's office here in the cities.

But I have heard he is very busy, I'm afraid it will take months to

get her in, but I suppose that will happen anywhere we go. But I

get so hopeful because she hasn't had an infection in two weeks and

she has gained another few ounces I think. Maybe if I just wait

they will prove to be right? But I don't want to waste time waiting

if she is not ok.

<<Give him a call. He knows his stuff.

He has expanded his practice and is far less hard to get an appointment with

than he was in the beginning.

Pam

mom to 4

Rebekah, 6, CVID and ??

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