Immune deficiency?

[jmom08]

It has been a long time since I posted, but found out some new info about my health, and in case it is at all related to PE and might help others, I thought I should make a note!

I thought I remembered reading (and am pulling up a couple of posts on search) about testing for immune issues as a possible contributing factor for PE, and am wondering if others have been advised of a link. I just found out I have low numbers for IGG2 and IGG4, and have been referred to an immunologist.

My history -- prior to my pregnancies, I frequently needed antibiotics to get over colds -- over half the time turned into sinus infections and/or chest infections. During my pregnancies and breastfeeding, I had a couple of mild colds but *no* sinus infections. Between pregnancies, I had two years of pretty much solid z-packs/medrol packs prescribed by an ENT, and a normal CT sinus scan. After I finishing breastfeeding approx 7 months ago, the colds started again and have had infections (or one long infection) ever since, and now have a yucky CT sinus scan and recommendation for surgery. The second ENT I saw suggested testing antibodies, so I guess now I know why I always need antibiotics, but am wondering if there is a possible PE link.

For those who remember me, apologies for not being on more often... the boys keep me hopping (literally). I will look around for updates on everyone! I have thought about the ladies who had babies 2009-2010 and hope all of you are doing well (everyone else too of course, but appreciated sharing the journey during that time!).

[alviarin]

Welcome back!

Very interesting thought about the immune deficiency, though I don't know if there is a link. As far as I know it is over-active maternal immune systems or incompatible immune systems ("dangerous partner" theory) that are thought to contribute to pre-e. Women with immune difficiency due to HIV infection have lower rates of preeclampsia.

I was sick a lot last year, so they tested my immoglobulin levels but everything came back normal. I had my tonsils out and sinus surgery last year too since I was sick of the re-occuring strep throat and sinus infections.

[tree]

I haven't heard of a link either, but I have had similar issues. I went 10 years without a sinus infection, then had 3 in the last couple of years. I get chest crud that requires steroids at least once a year now, and I've had shingles more times than I could count. I seem to be getting a little better, but not nearly back to pre-pregnancy immune system function. I might ask my doctor about this when I go in next time. I am pretty tired of having the crappy dysfunctional immune system.

I know that PE is linked to an overly active immune system. I wonder if it is linked to an overly active and totally ineffective immune system.

[Vickyjayne]

I am undergoing similar tests.
To cut a long story short I've had problems with my immune system for years. I was diagnosed with chronic fatigue syndrome when I was 15. Had glandular fever 3 times! First time I was hospitalised for 7 days. Then had constant chest/ ear infections and was always on antibiotics. This led to an episode when I had incredibly swollen lymph nodes In my neck which along with other symptoms led doctors to believe I may have had hodgkins lymphoma. After biopsies I was actually fine! They tested for lupus as for years I had always been so tired and picked up every infection going around. I'm now 31 and after having hellp syndrome I'm being tested for antiphospholipid syndrome. I've read that hellp can occur when an 'underlying autoimmune problem makes antibodies attack the blood (cardiolipin antibodies) making it sticky which can then cause blood clots. They believe this is what could have made my pre eclampsia/ hellp syndrome occur. I'm awaiting test results but they take 3 months.

I personally think its no coincidence that I got hellp of it can be brought on by autoimmune problems. If I test for this I will need warfarin injections to thin my blood out and aspirin during my next pregnancy.

[alviarin]

Vickyjayne,
Good luck with your test results. I had antibody testing due to a high ANA but everything came back negative.

I'm hoping last year was just an "off" year and I won't catch everything going around this year. Though before I started on thyroid meds I was exhausted all the time. I was just wondering as part of your testing if you have had your thyroid levels checked? Other auto-immune disorders can make you tired too, but thyroid disorders seem to be the most commonly occuring.

[Vickyjayne]

It's funny you should mention thyroid...when in hospital recovering from hellp I had a few I times where I would be covered in sweat. Like a fever when you have flu. (I had for many years 'night sweats' and this was a symptom investigated when there was a concern about hodgkins lymphoma. I was fine but these fevers were never explained. Anyway I had them again and I told the midwives I must have an infection somewhere. They checked my temperature which was fine and ran a check for infections but everything came back normal apart from my thyroid levels were abnormal. They were checked again by my doctor once I was back at home and they had returned to normal so it was put down to hellp affecting my thyroid. I'm not sure if they are checking my thyroid but they are doing anti coagulation tests, throbophillia, cardiolipin antibodies. I'm not really sure of what else but they took around 10/12 tubes of blood.

[Vickyjayne]

When you say you had ear infections....I had them every month. I would often go swimming and then pick up an ear infection in both ears. My immune system was basically none existent. Ive had that much amoxicillin during my life that it no longer clears up infections. The consultant read my medical history and decided to run these tests as she believed there may be a link. I am frightened for my next pregnancy. If you have read my story...I was ignored and felt like I was moaning! I was told I was having normal pregnancy pains. I just want to get to the bottom off all my immune system problems and if it is linked to my hellp then I will finally have some explanation as I feel very angry, hurt and confused why hellp happened to me.

[alviarin]

Vickyjayne,
Pre-eclampsia and HELLP syndrome do raise the risk of developing thyroid problems, but there is also something called postpartum thyroiditis where your thyroid gland goes wonky in the postpartum period. It usually resolves in the short term but puts you at greater risk of developing thyroid problems later in life or during subsequent pregnancies.

If I were you at a minimum I would ask for an annual TSH (Thyroid Stimulating Hormone) test to screen for hypothyroidism as recommended by the Endocrine Society for women who experienced postpartum thyroiditis.

And since untreated thyroid disease raises the risk of pre-eclampsia if you decide to TTC again I would make sure to have a full thyroid panel run including anti-thyroid antibodies.

Good luck, let us know what you find out when you get your test results back.

[Vickyjayne]

Well I am none the wiser as to why I developed hellp syndrome and had to have an emergency c section at 37 + 6 where my 5lb 9 son was delivered.
The specialist has basically dismissed me and written with my results but has stopped there in trying to identify why/ what happened to me! Typical NHS- useless!

My results are as follows

Cardiolipin antibodies (IGG) of 2.2 (<5.7)
Cardiolipin antibodies (IGM) of 1.0 (<10)

Both these are normal.
Normal level of functional protein C, APCR, prothrombin gene variant and free protein S. the functional antithrombin 3 level was slightly raised at 133% (normal 75-125)
The specialist has spoken to various haematologists who say this result has no bearing on my hypertension/ pre eclampsia/ hellp syndrome.

Will hellp strike in my next pregnant (I've not been told of the probability % of it occurring again.
How will I be managed next time (not been told)
I feel so let down as again I have been let down and failed by the NHS
They are not willing to alleviate my concerns as to why I could have died or whether I will be properly monitored in my next pregnancy.

I hope others get the answers they want so desperately.

[alviarin]

Vicky,
Sorry I don't know about antithrombin results, but I've found this a good website for helping to understand laboratory tests:
http://labtestsonline.org/understanding ... n/tab/test

I'm sorry to hear the specialist didn't address all your concerns. It is frustrutating not to have an answer to the question "Why?", but I'm glad your test results came back normal. On a postive note at least you have been able to rule some things out.

Although there are no guarantees, your odds of a sucessful second pregnancy are promising: http://www.preeclampsia.org/forum/viewt ... f=19&t=331

Since you mentioned post-partum thyroid issues, I would definitely get a yearly TSH test to screen for thyroid problems. And if you ever decide to TTC again make sure to get your thyroid checked first.