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:

I'm not really sure what they DID test for, I've never seen those

specific names. If I were you, I'd re-post this message with KIMBERLY in the

subject line, because she'd probably know!!! (, are you out there??!

:) )

What they test for in the United States is different pneumococcal STRAINS.

The strains have names like 18C, 14, 12F, 9N, etc. They usually test for the

most common strains encountered here, some of which are present in the

Prevnar conjugate vaccine. The strains you encounter in Australia could

possibly be different? Or maybe they are testing a general total antibody

count for all strep-pneumo bacteria (plus one strain - #2), and then only if

that's low they go on to test other strains?? Just guessing there.

Anyway, here's what they tested for, if this helps, but these are named

by a " U.S. classification system " :

S Pneumoniae AB IGG

S Pneumo 1 IGG

S Pneumo 3 IGG

S Pneumo 4 IGG

S Pneumo 6B IGG

S Pneumo 7F IGG

S Pneumo 8 IGG

S Pneumo 9N IGG

S Pneumo 12F IGG

S Pneumo 14 IGG

S Pneumo 18C IGG

S Pneumo 19F IGG

S Pneumo 23F IGG

These strains were all tested for us at: (they were shipped out there)

Specialty Laboratories Inc

2211 Michigan Avenue

Santa , CA 90404

Director: B. MD, PhD

Being in a different country, your tests may be quite different, I don't know!

(mom to , age 2, antibody def, IgA, IgM, IgG & subclass def - not

on IGIV yet)

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:

I'm not really sure what they DID test for, I've never seen those

specific names. If I were you, I'd re-post this message with KIMBERLY in the

subject line, because she'd probably know!!! (, are you out there??!

:) )

What they test for in the United States is different pneumococcal STRAINS.

The strains have names like 18C, 14, 12F, 9N, etc. They usually test for the

most common strains encountered here, some of which are present in the

Prevnar conjugate vaccine. The strains you encounter in Australia could

possibly be different? Or maybe they are testing a general total antibody

count for all strep-pneumo bacteria (plus one strain - #2), and then only if

that's low they go on to test other strains?? Just guessing there.

Anyway, here's what they tested for, if this helps, but these are named

by a " U.S. classification system " :

S Pneumoniae AB IGG

S Pneumo 1 IGG

S Pneumo 3 IGG

S Pneumo 4 IGG

S Pneumo 6B IGG

S Pneumo 7F IGG

S Pneumo 8 IGG

S Pneumo 9N IGG

S Pneumo 12F IGG

S Pneumo 14 IGG

S Pneumo 18C IGG

S Pneumo 19F IGG

S Pneumo 23F IGG

These strains were all tested for us at: (they were shipped out there)

Specialty Laboratories Inc

2211 Michigan Avenue

Santa , CA 90404

Director: B. MD, PhD

Being in a different country, your tests may be quite different, I don't know!

(mom to , age 2, antibody def, IgA, IgM, IgG & subclass def - not

on IGIV yet)

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I think has a point --

The immunos don't really bother to do ALL the testing because no matter what

your CVID specifics (in other words, as long as you're not SCID or candidate

for bone marrow transplant), there's only one treatment -- IGIV (or SCIG, but

it's still the same product).

That's why our immuno only wanted to check the pneumococcal titers this time,

I know she feels this 4th Prevnar won't have worked and she'll finally be

able to convince me to do IGIV. But I wanted to know what else was going on

in 's system and talked her into doing the other tests based on the fact

that 's over two yrs old now and maybe (yeah, right) some of her

problems were/are transient.

But if just a couple of tests plus your history indicate treatment is

necessary, I guess there's no need to test further, and I don't think a lot

of insurance companies would want to pay for extensive testing just because

you're curious about the particulars of your child's problem. Personally this

drives me nuts because I HAVE to know, you know? I want to know every single

aspect of the deficiency!

(mom to , age 2, antibody def, IgA, IgM, IgG & subclass def - not

on IGIV

yet)

P.S. I'm going to wait to get this blood draw I've been DYING to do, since

still has those pinpoint spots on her trunk. I've waited this long, I

might as well make sure she's completely well so we don't throw off the

results (though nobody's really sure that happens).

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I think has a point --

The immunos don't really bother to do ALL the testing because no matter what

your CVID specifics (in other words, as long as you're not SCID or candidate

for bone marrow transplant), there's only one treatment -- IGIV (or SCIG, but

it's still the same product).

That's why our immuno only wanted to check the pneumococcal titers this time,

I know she feels this 4th Prevnar won't have worked and she'll finally be

able to convince me to do IGIV. But I wanted to know what else was going on

in 's system and talked her into doing the other tests based on the fact

that 's over two yrs old now and maybe (yeah, right) some of her

problems were/are transient.

But if just a couple of tests plus your history indicate treatment is

necessary, I guess there's no need to test further, and I don't think a lot

of insurance companies would want to pay for extensive testing just because

you're curious about the particulars of your child's problem. Personally this

drives me nuts because I HAVE to know, you know? I want to know every single

aspect of the deficiency!

(mom to , age 2, antibody def, IgA, IgM, IgG & subclass def - not

on IGIV

yet)

P.S. I'm going to wait to get this blood draw I've been DYING to do, since

still has those pinpoint spots on her trunk. I've waited this long, I

might as well make sure she's completely well so we don't throw off the

results (though nobody's really sure that happens).

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http://www.specialtylabs.com/test/details.asp?id=2386

this is the test that we ran once before, it just gives a level of antibody.

http://www.specialtylabs.com/test/details.asp?id=2386P

this is the test that compares pre and post vaccinations results. It also

looks at the response in two ways. the first is whether there is a

protective level of antibody (>200) and then it looks at the ratio. The

ratio shows that an antibody response was mounted and that the person built

antibodies (> 4 fold).

Both tests compare 12 serotypes. Specialty does also offer a test that

shows 4 serotypes.

Ursula Holleman uahollem@...

and Macey's mom (5 yr. old with CVID, asthma, sinus disease, GERD,

kidney reflux, Sensory Integration Disorder, Diabetes Insipidus)

http://www.pedpid.com

/group/PedPID

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http://www.specialtylabs.com/test/details.asp?id=2386

this is the test that we ran once before, it just gives a level of antibody.

http://www.specialtylabs.com/test/details.asp?id=2386P

this is the test that compares pre and post vaccinations results. It also

looks at the response in two ways. the first is whether there is a

protective level of antibody (>200) and then it looks at the ratio. The

ratio shows that an antibody response was mounted and that the person built

antibodies (> 4 fold).

Both tests compare 12 serotypes. Specialty does also offer a test that

shows 4 serotypes.

Ursula Holleman uahollem@...

and Macey's mom (5 yr. old with CVID, asthma, sinus disease, GERD,

kidney reflux, Sensory Integration Disorder, Diabetes Insipidus)

http://www.pedpid.com

/group/PedPID

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Rebbeca,

I'm confused too, lol. When Chad was tested as a baby, they didn't have

such extensive testing as what they do now. With him being off IVIG for two

years, and just having been retested again, they just repeated the ones he's

always had. The only ones they do now is diptheria and tetanus antibody

response and titers and of course, the full immunoglobulin testing. He did

have the pneumovax and pneumoccal antibody testing in the past. And when he

was first diagnosed, he had both B cell and T cell testing done though I

don't know to what extent.

With what tests Chad has done, it shows up his deficiencies right away, so I

guess they haven't felt that they needed to put him through more than what

they do. I'm learning quite a lot here from all the mothers and will keep

it all in mind for future reference. So don't feel like the lone ranger out

there!! Hope is feeling much better!

, mother of Chad, age 9, " Hypo " , GERD, Asthma/Bronchitis, " Allergy

King " , Scoliosis, IGA Nephropathy and Anemia

Antibody levels

> Well, I am more than a little confused and somewhat concerned.

>

> It seems with alot of the posts that when it comes to Pneumococcal Ab

> testing, more than 2 types are looked at. The only Pneumococcal Ab

levels

> that has had tested are Pneumococcal IgG and Pneumococcal IgG2.

I'm

> not even sure if I understand about these two, let alone with the idea

that

> there are others that are routinely done in the US.

>

> I would like to talk to s immunologist about running more

extensive

> Ab testing, but would like to know what I should be asking for.

>

> , mum to (5) and (3), both with dysfunctional antibody

> def, selective IgA def, hypothyroidism, GI issues, asthma, and (Ricjard)

CPH

>

>

> 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.

>

>

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Rebbeca,

I'm confused too, lol. When Chad was tested as a baby, they didn't have

such extensive testing as what they do now. With him being off IVIG for two

years, and just having been retested again, they just repeated the ones he's

always had. The only ones they do now is diptheria and tetanus antibody

response and titers and of course, the full immunoglobulin testing. He did

have the pneumovax and pneumoccal antibody testing in the past. And when he

was first diagnosed, he had both B cell and T cell testing done though I

don't know to what extent.

With what tests Chad has done, it shows up his deficiencies right away, so I

guess they haven't felt that they needed to put him through more than what

they do. I'm learning quite a lot here from all the mothers and will keep

it all in mind for future reference. So don't feel like the lone ranger out

there!! Hope is feeling much better!

, mother of Chad, age 9, " Hypo " , GERD, Asthma/Bronchitis, " Allergy

King " , Scoliosis, IGA Nephropathy and Anemia

Antibody levels

> Well, I am more than a little confused and somewhat concerned.

>

> It seems with alot of the posts that when it comes to Pneumococcal Ab

> testing, more than 2 types are looked at. The only Pneumococcal Ab

levels

> that has had tested are Pneumococcal IgG and Pneumococcal IgG2.

I'm

> not even sure if I understand about these two, let alone with the idea

that

> there are others that are routinely done in the US.

>

> I would like to talk to s immunologist about running more

extensive

> Ab testing, but would like to know what I should be asking for.

>

> , mum to (5) and (3), both with dysfunctional antibody

> def, selective IgA def, hypothyroidism, GI issues, asthma, and (Ricjard)

CPH

>

>

> 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.

>

>

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In a message dated 3/26/2001 1:12:23 PM Eastern Standard Time,

bunneegirl@... writes:

> The immunos don't really bother to do ALL the testing because no matter what

> your CVID specifics (in other words, as long as you're not SCID or

> candidate

> for bone marrow transplant), there's only one treatment -- IGIV (or SCIG,

> but

> it's still the same product).

>

>

That is exactly what happened to Kody! The concesses was that Kody was sick

enough that it no longer mattered what we called it, but we knew enough that

he had an immune deficiency and started the IVIG without further testing. I

wish in a way that they had tested further first, but then I know how sick he

was and wouldn't have wanted him to be like that any longer either.

Diane, Mom to Kody age 5, IgG sub. class def., epilepsy,asthma,GERD, sinus

disease and , age 15, age 14, Arika age 13, Kaila age 9, and

age 7...all healthy!

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Hi ,

I had to respond to your letter....you are correct that many insurance

companies do not like to pay for expensive testing, but on the other hand,

most do not like to pay for IVIG, as it too, is quite expensive. A few

years ago when there was an IVIG shortage crisis...many patients had to be

placed on a priority list. Physicians had been putting patients on IVIG for

many other reasons then what it was intended for and this forced insurance

companies to really crack down on the over-use and misuse of IVIG. Many

physicians now, are being more careful and making sure that IVIG is

warranted, sometimes at the cost of additional testing I have known

families whose children were placed on IVIG under case management

supervision with the insurance company. I know that the IDF has had its

concerns with physicians misusing during the shortage crisis, etc and from

what I was told by our physician, they expect these problems to work out

over time.

Autumn (Mom to Mark Cd5-Cd19 PID and )

Re: Antibody levels

> I think has a point --

>

> The immunos don't really bother to do ALL the testing because no matter

what

> your CVID specifics (in other words, as long as you're not SCID or

candidate

> for bone marrow transplant), there's only one treatment -- IGIV (or SCIG,

but

> it's still the same product).

>

> That's why our immuno only wanted to check the pneumococcal titers this

time,

> I know she feels this 4th Prevnar won't have worked and she'll finally be

> able to convince me to do IGIV. But I wanted to know what else was going

on

> in 's system and talked her into doing the other tests based on the

fact

> that 's over two yrs old now and maybe (yeah, right) some of her

> problems were/are transient.

>

> But if just a couple of tests plus your history indicate treatment is

> necessary, I guess there's no need to test further, and I don't think a

lot

> of insurance companies would want to pay for extensive testing just

because

> you're curious about the particulars of your child's problem. Personally

this

> drives me nuts because I HAVE to know, you know? I want to know every

single

> aspect of the deficiency!

>

> (mom to , age 2, antibody def, IgA, IgM, IgG & subclass def -

not

> on IGIV

> yet)

>

> P.S. I'm going to wait to get this blood draw I've been DYING to do, since

> still has those pinpoint spots on her trunk. I've waited this long,

I

> might as well make sure she's completely well so we don't throw off the

> results (though nobody's really sure that happens).

>

>

> 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.

>

>

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Hi ,

I had to respond to your letter....you are correct that many insurance

companies do not like to pay for expensive testing, but on the other hand,

most do not like to pay for IVIG, as it too, is quite expensive. A few

years ago when there was an IVIG shortage crisis...many patients had to be

placed on a priority list. Physicians had been putting patients on IVIG for

many other reasons then what it was intended for and this forced insurance

companies to really crack down on the over-use and misuse of IVIG. Many

physicians now, are being more careful and making sure that IVIG is

warranted, sometimes at the cost of additional testing I have known

families whose children were placed on IVIG under case management

supervision with the insurance company. I know that the IDF has had its

concerns with physicians misusing during the shortage crisis, etc and from

what I was told by our physician, they expect these problems to work out

over time.

Autumn (Mom to Mark Cd5-Cd19 PID and )

Re: Antibody levels

> I think has a point --

>

> The immunos don't really bother to do ALL the testing because no matter

what

> your CVID specifics (in other words, as long as you're not SCID or

candidate

> for bone marrow transplant), there's only one treatment -- IGIV (or SCIG,

but

> it's still the same product).

>

> That's why our immuno only wanted to check the pneumococcal titers this

time,

> I know she feels this 4th Prevnar won't have worked and she'll finally be

> able to convince me to do IGIV. But I wanted to know what else was going

on

> in 's system and talked her into doing the other tests based on the

fact

> that 's over two yrs old now and maybe (yeah, right) some of her

> problems were/are transient.

>

> But if just a couple of tests plus your history indicate treatment is

> necessary, I guess there's no need to test further, and I don't think a

lot

> of insurance companies would want to pay for extensive testing just

because

> you're curious about the particulars of your child's problem. Personally

this

> drives me nuts because I HAVE to know, you know? I want to know every

single

> aspect of the deficiency!

>

> (mom to , age 2, antibody def, IgA, IgM, IgG & subclass def -

not

> on IGIV

> yet)

>

> P.S. I'm going to wait to get this blood draw I've been DYING to do, since

> still has those pinpoint spots on her trunk. I've waited this long,

I

> might as well make sure she's completely well so we don't throw off the

> results (though nobody's really sure that happens).

>

>

> 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.

>

>

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Hi ,

I had to respond to your letter....you are correct that many insurance

companies do not like to pay for expensive testing, but on the other hand,

most do not like to pay for IVIG, as it too, is quite expensive. A few

years ago when there was an IVIG shortage crisis...many patients had to be

placed on a priority list. Physicians had been putting patients on IVIG for

many other reasons then what it was intended for and this forced insurance

companies to really crack down on the over-use and misuse of IVIG. Many

physicians now, are being more careful and making sure that IVIG is

warranted, sometimes at the cost of additional testing I have known

families whose children were placed on IVIG under case management

supervision with the insurance company. I know that the IDF has had its

concerns with physicians misusing during the shortage crisis, etc and from

what I was told by our physician, they expect these problems to work out

over time.

Autumn (Mom to Mark Cd5-Cd19 PID and )

Re: Antibody levels

> I think has a point --

>

> The immunos don't really bother to do ALL the testing because no matter

what

> your CVID specifics (in other words, as long as you're not SCID or

candidate

> for bone marrow transplant), there's only one treatment -- IGIV (or SCIG,

but

> it's still the same product).

>

> That's why our immuno only wanted to check the pneumococcal titers this

time,

> I know she feels this 4th Prevnar won't have worked and she'll finally be

> able to convince me to do IGIV. But I wanted to know what else was going

on

> in 's system and talked her into doing the other tests based on the

fact

> that 's over two yrs old now and maybe (yeah, right) some of her

> problems were/are transient.

>

> But if just a couple of tests plus your history indicate treatment is

> necessary, I guess there's no need to test further, and I don't think a

lot

> of insurance companies would want to pay for extensive testing just

because

> you're curious about the particulars of your child's problem. Personally

this

> drives me nuts because I HAVE to know, you know? I want to know every

single

> aspect of the deficiency!

>

> (mom to , age 2, antibody def, IgA, IgM, IgG & subclass def -

not

> on IGIV

> yet)

>

> P.S. I'm going to wait to get this blood draw I've been DYING to do, since

> still has those pinpoint spots on her trunk. I've waited this long,

I

> might as well make sure she's completely well so we don't throw off the

> results (though nobody's really sure that happens).

>

>

> 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.

>

>

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,

I don't know the names of the B and T cell testing either. I'm hoping that

you'll get an answer because I'd like to know this too. I was just told

that my son was tested when he was first diagnosed.

I'm sorry that you haven't been able to find anyone in your country who is

living with this too. It was the same for me until finding this group.

Well, I did find one little boy but was unable to make contact with his

mother. So I understand how alone you feel.

And like you, reading all the posts here, I look back and think that there

were things that could've been done better and more aggressively for my son,

but I think everything has a reason and ours was to find the right doctors

and learn in the process.

Hang in there! I hope will soon be better and that you'll get to

the bottom of what is going on with him. Stay in touch!

Re: Antibody levels

> , I appreciate your reply!

>

> Seeing as how I was so fortunate to get such a wonderful response to this

> pneumococcal Ab question, I am going to continue to pick your minds a

little

> further. Hope you all dont mind! s immuno is not going to know

what

> hit him when I see him next! I'll be armed with all this info, and I

will

> not budge from my chair until I am satisfied with all my questions that I

> intend to fire away at him. And I am counting on the new ped to help

with

> all this, too.

> Ok, here is the new question- just what tests are ordered there to test B

and

> Tcell function? has had alot of various testing done in August

00,

> but I dont know the names of the B and T cell tests to make sure they were

> included. It was before the time of the current immuno, and I have all

the

> results with me for reference. I do know the chemotaxis essay was not

able

> to be done due to 'technical problems' in the lab. Is this one I should

ask

> to be re-run? What does it show if it IS re -run? The 'immune function'

> testing included Lymphocytes,monocytes, and granulocytes.

>

> I am sorry for all these nitty gritty questions, and hope no one minds me

> asking for these details.

>

> Ursula, thanks for you reply re: bicarb. And , too. It is a

relief

> to hear that the blood bicarb levels may not be indicating anything in

> particular. I had the impression from the immuno that he was looking for

> something specific, though. I dont know what, but it was the impression

he

> gave at the time. I dont have all the results of the testing he has

ordered

> for in the past, maybe there is something else in one of the lab

> results that he hasnt told me of yet, and he is putting two and two

together

> before he decides to share.

>

> , I'll reply to you weekend post later today......I can hear the

> children waking, so best go start the day.

>

> , mum to and

>

>

> 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.

>

>

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, you're very welcome!

Again, keep in mind I don't really know what it was that they tested your

for, I may be stirring up a hornet's nest for nothing! I can't

interpret the results (the #s) unless I know the parameters -- did you see

the actual results from the lab? They usually say what the parameters are for

a " normal " response.

The pre- and post- antibody question is a good one. Based on advice from the

group I asked my immuno about this very thing. It makes so much sense to do

pre- titers right before the test, right? Well, our immuno said they just use

the titers from the last test as their " pre- " level.

If I put on my turban and try to read her mind (;o)), I'd guess that if you

had some exposure in the meantime, AND the vaccine works, then would

have BIG numbers for that strain (so it's okay they don't know the #s right

before the test). And if he had some pneumo illnesses and didn't mount a

response in the meantime, well I guess you'd assume he won't mount a response

to the vax either.

AGAIN, that's just my guessing from info she's given us in the past, those

are not the immuno's words. GUESSING!!!!

Yes you may take my letter, though the docs will probably laugh at my

attempts to be medical!

(mom to , age 2, antibody def, IgA, IgM, IgG & subclass def - not

on IGIV yet)

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, you're very welcome!

Again, keep in mind I don't really know what it was that they tested your

for, I may be stirring up a hornet's nest for nothing! I can't

interpret the results (the #s) unless I know the parameters -- did you see

the actual results from the lab? They usually say what the parameters are for

a " normal " response.

The pre- and post- antibody question is a good one. Based on advice from the

group I asked my immuno about this very thing. It makes so much sense to do

pre- titers right before the test, right? Well, our immuno said they just use

the titers from the last test as their " pre- " level.

If I put on my turban and try to read her mind (;o)), I'd guess that if you

had some exposure in the meantime, AND the vaccine works, then would

have BIG numbers for that strain (so it's okay they don't know the #s right

before the test). And if he had some pneumo illnesses and didn't mount a

response in the meantime, well I guess you'd assume he won't mount a response

to the vax either.

AGAIN, that's just my guessing from info she's given us in the past, those

are not the immuno's words. GUESSING!!!!

Yes you may take my letter, though the docs will probably laugh at my

attempts to be medical!

(mom to , age 2, antibody def, IgA, IgM, IgG & subclass def - not

on IGIV yet)

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, you're very welcome!

Again, keep in mind I don't really know what it was that they tested your

for, I may be stirring up a hornet's nest for nothing! I can't

interpret the results (the #s) unless I know the parameters -- did you see

the actual results from the lab? They usually say what the parameters are for

a " normal " response.

The pre- and post- antibody question is a good one. Based on advice from the

group I asked my immuno about this very thing. It makes so much sense to do

pre- titers right before the test, right? Well, our immuno said they just use

the titers from the last test as their " pre- " level.

If I put on my turban and try to read her mind (;o)), I'd guess that if you

had some exposure in the meantime, AND the vaccine works, then would

have BIG numbers for that strain (so it's okay they don't know the #s right

before the test). And if he had some pneumo illnesses and didn't mount a

response in the meantime, well I guess you'd assume he won't mount a response

to the vax either.

AGAIN, that's just my guessing from info she's given us in the past, those

are not the immuno's words. GUESSING!!!!

Yes you may take my letter, though the docs will probably laugh at my

attempts to be medical!

(mom to , age 2, antibody def, IgA, IgM, IgG & subclass def - not

on IGIV yet)

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,

Chemotaxis is one step of killing of a bacteria -- essentially a step

where the cell uses a chemical (hence, the " chemo " ) to intervene and

lyse (break open) the cell. Usually that chemical is hydrogen peroxide,

produced inside the cell. Impaired cell chemotaxis is indicative of a

specific PID called Chronic Granulomatous Disease, and the specific test

for that is usually called the NBT, or Nitrile Blue Test. I'd ask for

it to be done. 's profile doesn't exactly fit CGD, but then it

doesn't really " fit " anything else, either -- he's sick, and they need

to look into everything they can. The treatment wouldn't change much

for CGD except to cover for specific bacteria, respond differently to GI

problems, and offer the chance of stem cell transplant (just been tried

in the US, probably had been done in UK before that). As you know, CVID

isn't treated with transplant, typically, so that's the biggest

difference.

Other tests that are often ordered:

Pre/post pneumococcal (and to answer your question, I'd want one drawn

now, rather than 7 months ago, or something, to compare with the post titer)

Diptheria titer

Tetanus titer

Total IgG

IgG subclasses

IgA

IgM

IgE

Total lymphocyte panel (CD3, CD4, CD8, CD19, CD56, % and absolutes)

B cell " function " is measured primarily by the Pre-Post Pneumococcal panel

T cell function is measured by mitogen tests against PHA

(Phyto-Hemagglutinin), Con-A (Concavalin-A), and PWM (Pokeweed Mitogen),

and Antigen tests against Candida, Tetanus, Diphtheria, or any other

random things you would expect to be exposed to.

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,

Chemotaxis is one step of killing of a bacteria -- essentially a step

where the cell uses a chemical (hence, the " chemo " ) to intervene and

lyse (break open) the cell. Usually that chemical is hydrogen peroxide,

produced inside the cell. Impaired cell chemotaxis is indicative of a

specific PID called Chronic Granulomatous Disease, and the specific test

for that is usually called the NBT, or Nitrile Blue Test. I'd ask for

it to be done. 's profile doesn't exactly fit CGD, but then it

doesn't really " fit " anything else, either -- he's sick, and they need

to look into everything they can. The treatment wouldn't change much

for CGD except to cover for specific bacteria, respond differently to GI

problems, and offer the chance of stem cell transplant (just been tried

in the US, probably had been done in UK before that). As you know, CVID

isn't treated with transplant, typically, so that's the biggest

difference.

Other tests that are often ordered:

Pre/post pneumococcal (and to answer your question, I'd want one drawn

now, rather than 7 months ago, or something, to compare with the post titer)

Diptheria titer

Tetanus titer

Total IgG

IgG subclasses

IgA

IgM

IgE

Total lymphocyte panel (CD3, CD4, CD8, CD19, CD56, % and absolutes)

B cell " function " is measured primarily by the Pre-Post Pneumococcal panel

T cell function is measured by mitogen tests against PHA

(Phyto-Hemagglutinin), Con-A (Concavalin-A), and PWM (Pokeweed Mitogen),

and Antigen tests against Candida, Tetanus, Diphtheria, or any other

random things you would expect to be exposed to.

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Guest guest

Yikes - that's what I get for sending mail when I'm bleary-eyed!

First, I lied. Chemotaxis isn't killing with chemicals, it's basically

cells' ability to talk to each other with chemicals. That is, one cell

finds a bacteria or pack of them, and it sends signals to other cells of

the same type by putting out a gradient of chemical. So the highest

amount of chemical is right there where the bad guy is to be faught, but

there's a diminishing trail leading away from it, so that other cells

can " follow the scent " in a way, to help out killing the bad guy. I

don't remember the name for the problem in CGD, but it sounds similar,

and I'll no doubt remember it as soon as I hit the send button!

The tests that I wrote are not to be taken as a complete list, because

there are lots of others that can be done, or probably should be done,

depending on how sick someone is, but that was a start. In someone with

CVID, I would probably want a baseline CBC, ANA, and ESR (sed rate), if

only to compare to future numbers. Again, the lists could go on

forever, but that was a beginning.... let me know if there are specific

tests you're thinking of and wondering if they're useful.

I hope that helps... sorry for the mistakes/omissions -- long week!

Take care,

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Guest guest

Yikes - that's what I get for sending mail when I'm bleary-eyed!

First, I lied. Chemotaxis isn't killing with chemicals, it's basically

cells' ability to talk to each other with chemicals. That is, one cell

finds a bacteria or pack of them, and it sends signals to other cells of

the same type by putting out a gradient of chemical. So the highest

amount of chemical is right there where the bad guy is to be faught, but

there's a diminishing trail leading away from it, so that other cells

can " follow the scent " in a way, to help out killing the bad guy. I

don't remember the name for the problem in CGD, but it sounds similar,

and I'll no doubt remember it as soon as I hit the send button!

The tests that I wrote are not to be taken as a complete list, because

there are lots of others that can be done, or probably should be done,

depending on how sick someone is, but that was a start. In someone with

CVID, I would probably want a baseline CBC, ANA, and ESR (sed rate), if

only to compare to future numbers. Again, the lists could go on

forever, but that was a beginning.... let me know if there are specific

tests you're thinking of and wondering if they're useful.

I hope that helps... sorry for the mistakes/omissions -- long week!

Take care,

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Guest guest

,

Your post made sense, so it looks as though can do without another

traumatic needle stick until after the pneumovax has been given.

Oh, and by the way, the report for the pneumoccocal ab. results did not have

ranges or parameters for that particular test, just the results I gave. I

thought this was a little strange at the time........

How is doing?

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Guest guest

,

I know you must hear this all the time, but do you truly TRULY relise how

valuable your help, concern, and information is to all of us???

Thankyou from the bottom of my heart,

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Guest guest

,

I know you must hear this all the time, but do you truly TRULY relise how

valuable your help, concern, and information is to all of us???

Thankyou from the bottom of my heart,

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Guest guest

,

I know you must hear this all the time, but do you truly TRULY relise how

valuable your help, concern, and information is to all of us???

Thankyou from the bottom of my heart,

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Guest guest

,

What is the ESR (sed rate) all about? I have heard alot mentioned in the

group of sed rate, but have no idea what it means, and what it is for!

Also, what is Endomysial Ab all about? s results read negetive. Is

this good?

You may be reading this and smiling at my nievity. Well, you dont know if

you dont ask!

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