Very low LAD in pregnancy after 2*LIT

Springflower

1 Posts
Reply Posted on: Dec 11, 2012 at 3:20am
Dear Dr Baverman

Firstly I've only just discovered your website, it's amazing! Very very useful.

I'm hoping you can help. I'm currently 20ws pregnant and have just retested my LAD.

The results are below
Flowcytometry Negative
[T-cells] IgM+ 1.0
[T-cells] IgG+ 1.0
[B-cells] IgM+ 4.1
[B-cells] IgG+ 1.2

I had two shots of paternal LIT in September because my results were a bit borderline. I cant understand how they have decreased so much?

Here are they August results

Flowcytometry Positive
[T-cells] IgM+ 6.3
[T-cells] IgG+ 59.7
[B-cells] IgM+ 24.8
[B-cells] IgG+ 40.7

This was a natural pregnancy which has taken us by surprise. I gave birth at 29wks to twins in February and I'm now wondering if the premature labour had something to do with low LAD?

I suffer with high NK cells and have been having an IVIG every 3.5 wks to try to lower them. (Intralipids don't seem to work with me.) at the time of having LIT I was on 40mg of pred (I'm not sure whether that affected my results?)

Any insight or advice will be greatly appreciated. I lost one of our twins and as a result I'm very frightened of loosing this baby.

Many thanks

Dr. Braverman

2026 Posts
RE: Very low LAD in pregnancy after 2*LIT Posted on: Dec 11, 2012 at 6:10am
During preganancy the production of anti idiotypic antibodies may lessen the amount of anti paternal HLA antibodies, i.e. those created from LIT. LAD is an indirect measure of the anit idiotypic or "protective" antibody which form in response to the ant HLA antbodies , whose consistent high levels may actually be a poor prognostic indicator. so Im not sure you are still taking the LIT? Also IVIG will lower anti HLA antibodey the same one you are testing for on the LAD? Again this should be explained clearly so you undertand.
I think at this point you are fine , not sure why you are continuing any treatments. I dont know your case so again this is a very superficial opinion. I would be happy to assist you , you can call my office and I can review your case wtih you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.