This is what the Reproductive Immunologist had emailed me in November 2010.
“Here is what we found:
Your NKT (Natural Killer T)cells were very elevated and this has been shown to be one of the most significant findings in women with recurrent pregnancy loss. The good news is that in this group of women where the losses are due to elevated NKT cells those that respond to treatment by lowering the NKT count have a very high rate of success. As these cells are the most potent producers of inflammatory cytokines (TH1) we look for elevations of TH1 to see if the NKT are active and of the TH1 type. Your TH1 was also very elevated. Both of these issues also drive division of your regular NK cells to the more “toxic” form called CD56/16 and again those are elevated in your case.
T cells are another set of white blood cells that unlike NK cells (which attack “anything” that looks foreign) have to be preprogrammed to attack something very specific. In your case we found that your T cells had receptors on their surface that showed they had been activated called an IL2 receptor. All of this together with the fact that your ANA, and ATA(thyroid antibodies) were positive is a convincing argument that your embryos are not able to generate the immune tolerance necessary to turn off your immune system and your immune system is simply destroying the embryos.
We can treat these issues with the best treatment right now being IVIG (we are starting a new treatment protocol called neupogen) which has also shown to be very effective in these cases as well. In addition because of possible clotting issues related to the pos ANA and elevated TH1, lovenox would be started as well and you would need a broad spectrum anti inflammatory called prednisone. You have another phospholipid antibody called lupus anticoagulant, I would like to run a few more tests.”
I guess I knew there would be more blood tests. I will not have all of those tests done again. I had 7 vials taken in their office, 8 vials done at the local lab and 47 (some of which were small 1ml/cc) vials at a BioReference lab (I almost passed out). Scary stuff.
Here is a little background on the immune issues from http://www.preventmiscarriages.com :
“Immunologic Causes of Multiple Miscarriages;
When the immune system is functioning correctly, it is able to recognize a pregnancy as a desirable condition within the body, even though the embryo will initially appear foreign to the mother. The embryo then proceeds to suppress the mother’s immune system from its normal and usual activity of attacking foreign entities and in it actually initiates certain processes whereby it directs the mother’s immune system to protect the embryo from attack by other sources. If the immune system is defective, however, these actions do not occur and the immune system itself can attack the embryo and cause recurrent miscarriages.
There are many complex ways in which these issues with the immune system manifest and interfere with the natural process in which the embryo helps itself. If you are wondering, “What is immunology?” and how it may be affecting your efforts to achieve a successful pregnancy, Dr. Braverman and our team can help. We can explain in simple terms all about autism,blocking antibodies, natural killer cells , natural killer T cells and activated T cells, HLA function, HLA matching and how certain HLA genes can cause miscarriages. We can also go over positive ANA and positive ATA, positive APA, positive ACA, T regulator cells, cytokines, dendritic cells and macrophages, activated T cells, proliferating B cells, and progesterone and beta HCG function.
I got very sick after I heard all of the above. It took me a long time to accept and understand all of this. I am a little nervous as to what he will say to me now. It’s been two and a half years now and I wonder if he will be able to help now. I am working on being optimistic about the consult.