Low LAD and IVIG?

Leslieco12

6 Posts
Reply Posted on: May 4, 2014 at 11:20am
Hi. Dr. Braverman. I have 5 CGH normal blasts frozen and am trying to figure out how to proceed. I have had 5 chemical pregnancies, one ectopic and a live birth at 38.5 weeks. 3 of those chemical pregnancies were after my live birth, and 2 were with CGH normal blasts.

I had extensive immune testing after the last two CPs and I had very high NK activation and low LAD. I was retested this week and the NKs have returned to normal (with no treatment) and the LAD is even lower. I was recommended LIT, which I can't do, and if not LIT, then IVIG.

I've read that you do not recommend treating low LAD? Is that still the case? And if so could you point me to any literature I might read on the topic? Thank you. My LAD results are below:[T-cells] IGM+ 4.8
[T-cells] IGG+ 1.7
[B-cells] IGM+ 3.4
[B -cells] IGG+ 2.2

Dr. Braverman

2026 Posts
RE: Low LAD and IVIG? Posted on: May 4, 2014 at 6:59pm
I dont have one source for this but the literature is clear that you wont develop anti paternal HLA antibodies until there has been adequate exposure to paternal antigen from a pregnancy of moderate duration(see my blog on this on my website). NK cells alone are not a "diagnosis" but just a symptom. Patients do not have immune abnormalities for no reason, there is always an underlying autoimmune (sometimes allo immune ) issue that needs to be diagnosed then the entire immune panel evaluated. Its only in this context that you can give an accurate treatment protocol.
Please fill out a consult request from my website and we will schedule a free 10 minute chat so we can reveiw your case in detail.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Leslieco12

6 Posts
Reply RE: Low LAD and IVIG? Posted on: May 4, 2014 at 7:46pm
Hi -- I actually have had extensive testing. I had elevated thyroid antibodies at one point (around 150) which my doctor thought caused the NK elevation. I was on synthroid for my first pregnancy but now my TSH is normal (usually around 1.5). I had my thyroid antibodies tested again and they are down to 20.

I have had a full term pregnancy resulting in a live birth.

Dr. Braverman

2026 Posts
RE: Low LAD and IVIG? Posted on: May 5, 2014 at 7:22am
Please see the Diagnostic testing section and the sample reports to understand what a "complete" evaluation is, you had "some" testing but you do not have a diagnosis that explains the findings;. The thyroid issues may be Hashimotos, and elevation of NKa or other NK cell parameters could be antibody dependant cellular cytotoxicity(ADCC), but I couldnt begin to offer treatments until I was sure and after you had the complete workup.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Leslieco12

6 Posts
Reply RE: Low LAD and IVIG? Posted on: May 5, 2014 at 7:36am
I've had the Beer center workup, what else do I need?

Dr. Braverman

2026 Posts
RE: Low LAD and IVIG? Posted on: May 5, 2014 at 9:10am
Please see my Diagnostic Testing Section to see what else you need. I would advise that you get my complete workup.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.