Poor chances with HLA matches?

Michelle87

2 Posts
Reply Posted on: Dec 12, 2013 at 11:08am
Dear Dr. Braverman,

Thank you for this forum! My husband and I had immune testing in April and recently did HLA matching as well. These are our results:

Husband (age 38);Me (age 37)
A 02, 23; 23,29
B 08,51; 41,45
C 01,07; 06,07
DRB1 3,11,DRB3 present; 08,13
DQalpha 05,05; 01,05
DQbeta 02,03; 03,06

4/2013 Immune TestingAPAIgM phosphoethanolamine PositiveIgM phosphoglycerol High PositiveIgG cardiolipin BorderlineIgG phosphoinositol BorderlineIgG phosphatidic acid High PositivePAI-1 heterozygous mutatedHPA-1a positiveFactor XIII Heterozygous mutatedNK Assay50:1 19.725:1 14.612.5:1 9.9CD3 81.7CD19 8.4CD56 9.0CD19+cells, CD5. 6.3TNF-a:IL-10 (CD3+CD4+) 39.2 (H)IFN-g:IL-10 (CD3+CD4+) 17.2

I have had in order a blighted ovum, full term son, 20 week loss of heartbeat, full term daughter, chemical, IVF1 blighted ovum abnormal female, IVF2 twin loss one at 6 weeks one at 11 weeks (normal female). No immune treatments or anticoagulants other than progesterone, flaxseed and evening primrose.

Do our HLA results make our chances poor? What is our DQalpha percentage? Would we need to use Neupogen or would other treatments possibly work? Thank you!

Dr. Braverman

2026 Posts
RE: Poor chances with HLA matches? Posted on: Dec 17, 2013 at 12:08pm
We look at your HLA types not to see what immune syndrome you have but to see what your predisposition is. This gives us a good idea of the funciton of your HLA genes.

1. You dont have any HLA mathcing issues .
2. There are no issues with production of HLA G based on your HLA hapoltypes
3. Therre are a few immune predispositions that may explain your being postive for APA.

this is not typically a case we use neupogen , more likley immune suppression with lovenox / prednisone.

Again I do not know all of the details of your case , so this is just my thoughts based on what you presented me with . The ultimate decision of your care must be with your doctor who knows your case.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Michelle87

2 Posts
Reply RE: Poor chances with HLA matches? Posted on: Dec 28, 2013 at 8:06pm
Dr. Braverman,

Thank you so much for your response! I was very worried about the HLA matches since we were given a poor prognosis with our DQalpha matches.

I am hoping lovenox and prednisone will be sufficient. Since my TNFa is 39.2, do you think prednisone alone could work without having to use IVIG? Does LIT help with any of my issues?

Thank You!!

Dr. Braverman

2026 Posts
RE: Poor chances with HLA matches? Posted on: Dec 28, 2013 at 8:33pm
again , I do not know your history well so only your doctor should make specific recommendations. However with the limited information that I have I feel that lovenox and prednisone are reasonable options here. IVIG in addition would help , I would want to know your HLA antibody status run by luminex platform to better assess the need for IVIG>
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.