Dear Dr. Beer,
I made NK cells test again and this is lab report:
CD3+(T-lymphocytes) 63.9 (normal referent.60-85 %)
Normal
CD19 + (B-lymphocytes) 11.2 (normal referent. 5-20%)
Normal
CD3+/CD4+(secondary T-lymphocytes) 42.3 (normal referent. 35 - 60 %)
Normal
CD3+/CD8+(T-Cytotoxic-lymphocytes) 23.2 (normal referent. 10-30 %)
Normal
CD3-/CD56+(NK cells) 18.2 (normal referent. 0-15 %)
High.
I have not seen a live born child in any woman with levels 18 or higher without IVIG and LIT therapy. Many need also Enbrel or Humira if they have NK cells in the uterus.
CD3+/HLA-DR+(activated T-lymphocytes) 1.3 (normal referent. 0-10 %)
Normal
Absolute number CD4+ T-lymphocytes/uL blood: 566 (normal ref. 500-1500/uL)
Normal
Rate CD4+/CD8+T-lymphocytes 1.8 (normal referent. 1.9 (1-3.6)
Low
Comment: elevated NK Cells in peripheral blood.
I agree. I would love for you to have the NK assay with and without the addition of IVIG and the TH1 TH2 cytokine assay. I also want you to consider having an endometrial biopsy for NK cells on cycle day 26 or a day or two before you begin your menses
Percentage of IL-10+CD8+T-cells in the peripheral blood was 1.6%
(laboratory normal ranges 07-2.2%)
This is normal.
I also made Function of HLA Antigens and this is my lab report:
Locus HLA-A
Phenotype HLA = 2, 3
Locus HLA-DR = 13,8
Locus HLA-Cw = NT, NT (NT=no typed)
DR 51; 52; 53 = 52, NT
Locus HLA-B = 27, ND (ND=not defined)
Locus HLA-DQ = 1, NT
Bw4: w6 = NT, NT
DNK: Locus DRB1 = NT, NT
I would like to have your husband have the HLA typing also. If you share you will need LIT and most likely Enbrel or Humira.
Panel Reactive Antibodies
Class I : 00/00/30
Cross-Match test: B+TLy = neg. (-)
This latter B cell antibody should be above 30%. I recommend the LIT therapy. If you share DR or DQ alpha with your husband I will recommend donor plus paternal.
MLC test = low reactivity
Good level. Low is better.
And my husband HLA Antigens report is:
Locus HLA-A
Phenotype HLA = 3, ND
Locus HLA-DR = ND, ND
Locus HLA-Cw = NT, NT (NT=no typed)
DR 51; 52; 53 = ND, ND
Locus HLA-B = 35, 39
Locus HLA-DQ = ND, ND
Bw4: w6 = NT, NT
DNK: Locus DRB1 = 04,14
Please arrange for DQ alpha. He is probably 4.1 / 4.1
Now (after therapy Euthyrox 75 mg) my TSH level is: 1.34 mIJ/l, but AMA and ATA antibodies are high positive.
The TSH must be kept in the one level. Your dosage is fine.
Here in Croatia not exist LIT therapy, but I ask for IVIG and we have some Gammagard Baxter, is that's OK and what's Yours opinion ?!
Yes, 25 grams on cycle day 6, -2 days before ovulation or transfer if IVG and again with a positive pregnancy test. We test the NK and the TH1 TH2 cytokine assay 7 to 10 days after the first or second IVIG.
Thank you in advance for your answer,
greetings from Croatia (Zagreb)
Warm Regards
Alan E Beer, MD