MedWorm Tags: igg

Persistent Thrombocytopenia in ITP

Inside Surgery — Mon, 03 Jan 2011 06:47:46 +0100

By definition platelet counts drop in immune thrombocytopenic purpura and successful treatment of the condition is measured by an increasing platelet count. The first-line treatment is the use of corticosteroids, which is successful in about two-thirds of patients and particularly successful in children. Administration of intravenous IgG and the use of plasmapheresis will also temporarily increase platelet counts and are used in cases of bleeding due to a severely reduced platelet count (< 15,000/microL). For refractory cases, splenectomy can be considered. If platelet counts are still decreased several months after splenectomy, a blood smear for Howell-Jolly bodies should be obtained. If there is an absence of Howell-Jolly bodies, a sulfur colloid scan for accessory spleen should be perfo...

Test results and other stuff

beth's myeloma blog — Mon, 14 Jun 2010 20:17:34 +0100

I had blood drawn on 6/3, and got the results back today. Test: Result (Normal Range) IGG: 455 (600-1700) IGM: 34 (35-290) IGA: 466 (40-400) This is from last time, so you can see there’s not much change! IGG: 466 (600-1700) IGM: 31 (35-290) IGA: 408 (40-400) I found a new web site that I’m still checking out. It has details about lab tests and other info. http://www.clinlabnavigator.com/ Anyway, the doc says I’m still smoldering! I was at Five Points Pet Resort a couple of weeks ago, where this green-winged macaw engaged us. He has a lot of personality! (Source: beth's myeloma blog)

Latest electrophoresis, proteins and free light chains

beth's myeloma blog — Tue, 02 Feb 2010 20:43:21 +0100

Here are my latest results. Specific Proteins Test Name Result AB Normal Range Units IGG 466 L 600-1700 MG/DL IGM 31 L 35-290 MG/DL IGA 408 H 40-400 MG/DL Electrophoresis The SPE pattern demonstrates two bands of restricted mobility in the gamma region. Immunofix, Serum Monoclonal component typed as IgA Lambda. Concentration of monoclonal protein determined by serum protein electrophoresis is 0.4 g/dL. Monoclonal component typed as IgA Lambda. Concentration of monoclonal protein determined by serum protein electrophoresis is 0.3 g/dL. *Suggestive of a monoclonal component typed as IgG Kappa. Concentration of monoclonal protein is too low to accurately quantify. * This is new! Previously, I’ve only ever had just two m-spikes. That’...

Virus neutralization by antibodies

virology blog — Fri, 24 Jul 2009 13:00:28 +0100

The antibody response is crucial for preventing many viral infections and may also contribute to resolution of infection. When a vertebrate is infected with a virus, antibodies are produced against many epitopes on multiple virus proteins. A subset of these antibodies can block virus infection by a process that is called neutralization. Antibodies can neutralize viral infectivity in a number of ways, as summarized in the illustration. They may interfere with virion binding to receptors, block uptake into cells, prevent uncoating of the genomes in endosomes, or cause aggregation of virus particles. Many enveloped viruses are lysed when antiviral antibodies and serum complement disrupt membranes. Non-neutralizing antibodies are also produced after viral infection. Such antibodies bind ...

2009 Myeloma update

beth's myeloma blog — Thu, 15 Jan 2009 08:14:49 +0100

I don’t have a lot to blog about here because my myeloma has been stable since last fall. There’s not much there at all. If you don’t have myeloma, I have only a little bit more than you do. These labs were done 12/08/2008 IFE SERUM (2) MONOCLONAL IgA-LAMBDAS DETECTED BY IFE. SPE M-SPIKE 1 0.17 g/dL SPE M-SPIKE 2 0.12 g/dL IG FREE LIGHT CHAINS SERUM Reference IG FREE LIGHT CHAIN KAPPA *0.16mg/dL [0.33-1.94] IG FREE LIGHT CHAIN LAMBDA 1.85mg/dL [0.57-2.63] IG FLC KAPPA/LAMBDA RATIO *0.09 [0.26-1.65] IMMUNOGLOBULIN PROFILE IMMUNOGLOBULIN G *374mg/dL [588-1573] TEST REPEATED TO CONFIRM IMMUNOGLOB...

Classic myeloma? A bit of an explanation.

beth's myeloma blog — Sat, 08 Nov 2008 17:32:41 +0100

On the mailing list we had a discussion about bone disease in MM. Here’s what Nancy said about it. I hadn’t realized before that IgA patients are less prone to bone disease. One of my doctors did tell me we’re more likely to have kidney involvement though. Some people never have bone disease…that’s just the way their myeloma is; just as some people never have kidney problems. The names given to the variations of myeloma are not different. Patients with IgA myeloma are less likely to have bone disease than those with IgG myeloma…and those with IgG myeloma are less like than those with IgA myeloma (or Bence Jones myeloma) to have kidney problems. Perhaps by “classic myeloma” they are referring to myeloma that is in the bone marrow…as ...

Holford Recommends a Nutritional Approach to Hayfever: What's the Quality of the Evidence?

Breath Spa for Kids — Wed, 25 Apr 2007 23:18:00 +0100

And please let Shinga read some decent research papers before she explodes.Several valued correspondents have brought Patrick Holford's nutritional recommendations for people with hayfever to my attention. Holford's PR people are to be congratulated because the same press release appears in many places in the form of articles about dealing with hayfever: one of the most recent of these is in the Manchester Evening News, Supplements to Solve Hayfever Sniffles. There is a more detailed account of Holford's claims regarding particular supplements and hayfever on his own site.I'm going to state right here that there is negligible evidence to support Holford's claim that:MSM has so many benefits for allergy sufferers that it’s hard to know where to start.I will enlarge upon why I reject this ...

What Does Allergy UK's Consumer Award for Products Mean?

Breath Spa for Kids — Wed, 25 Apr 2007 17:09:00 +0100

When Muriel Simmons joined Allergy UK she reorganised its finances and introduced a successful endorsement scheme.The charity realised that an endorsement scheme would benefit three different groups. Firstly, it would provide a vital service to the public; secondly, it would revitalise their own turnover; and thirdly, with one in three members of the population suffering an allergy, an endorsement would supply an obvious marketing tool for manufacturers."I felt it would be a service to the public with allergies to say that we had tested the product and found that the criteria laid down by the experts (which were incredibly high) had been met." - Muriel SimmonsThe idea evolved from the fact that sufferers were frequently contacting Allergy UK for advice on consumer decisions. They wanted to...

Why Results from an Allergy or Intolerance Test May Be Misleading: Part 2

Breath Spa for Kids — Sat, 21 Apr 2007 14:48:00 +0100

You might expect a clinical test to have results that would be the same in any laboratory where a sample was tested and to be reproducible, e.g., the same result when tested on a different day. Beyond this, according to Dr. Adrian Morris:An Allergy Test should reliably identify one or more agents to which the patient reacts on each exposure. These allergens must be the cause of the patient’s immune-mediated allergic symptoms. This reaction need not necessarily be IgE mediated, but may involve a T-cell Delayed hypersensitivity reaction or direct Histamine release from Mast Cells and Basophils. The test should be reproducible and identify the implicated allergen on each occasion the test is done. The allergy should be specific to that allergen with minimal false positive test results (when...

Why Results from an Allergy or Intolerance Test May Be Misleading: Part 1

Breath Spa for Kids — Sun, 15 Apr 2007 15:34:00 +0100

There are significant problems involved with direct-to-consumer (DTC) testing for allergies and intolerances. Dr. Scadding characterised some of these self-tests as a waste of money and in response to a question about whether she considered that these tests were sufficiently regulated, she answered, "They should be banned". She went on to outline some of the harm that is experienced by children when they are misdiagnosed or if they pursue unnecessary allergen avoidance.Dr. Scadding discussed a recent example that illustrates some of the potential problems for consumers who have access to direct-to-consumer tests.Dr. Scadding: For example, I saw a child this morning before coming here and she had...We did skin tests that are well recognised and she had skin tests to house dust mite and also...

YorkTest and the Number Needed to Treat in Food Intolerance Tests

Breath Spa for Kids — Sat, 14 Apr 2007 10:53:00 +0100

And please let Shinga read some decent evidence before she explodes.Let's face it. The Number Needed to Treat (NNT) is a nuisance. Boring statisticians and people who want a fuller understanding of results from clinical trials bang on about its usefulness but isn't it about time that these people got a life? Because in any clinical trial, we all know that the important people are the ones for whom the protocol worked, particularly if it means that it will at some point provide someone with beans on toast, a roof over the head, a really nice box of pencils or a car...Who cares about the people who couldn't comply with a protocol because it was too onerous to (say) exclude wheat, milk, egg, corn and soy from the diet? Who cares about the people who don't stick with their anti-hypertension me...

Self-Testing for Allergy and Intolerance in the UK: Part 1

Breath Spa for Kids — Thu, 12 Apr 2007 16:11:00 +0100

Last month, I wrote up part of an House of Lords evidence session for allergy and allergic disease in which IgG food intolerance tests were described as a waste of money. The first part of that session was less entertaining but does give an insight into the regulatory mess that surrounds self-testing kits in the UK. Patrick Holford (amongst others) describes the availability of these self-tests as empowering and suggests that: some health professionals just haven’t kept up to date. Perhaps it’s because a ‘home test’ takes the power away from the professional and puts it in your hands.Not withstanding Holford's comments there are serious questions about the harm to children that arises from misdiagnosis or the inappropriate use of allergy and intolerance tests.The transcript for the...

Why Both Misdiagnosis or Inappropriate Allergy and Intolerance Tests Can Harm Children

Breath Spa for Kids — Mon, 19 Mar 2007 11:19:00 +0100

I have been writing a lot about allergy and intolerance tests recently; a number of factors have contributed to this. The House of Lords is currently scrutinising allergy and intolerance in the UK. When I look through the medical histories of the children with whom I work, in 60-80% of them, the parents have usually indicated that there are several allergies and intolerances. I would estimate that there is clinical confirmation of these allergies etc. in fewer than 2% of the children.It is breathtakingly difficult to obtain a referral to a clinical allergist in the UK. In the whole of the UK, we have the equivalent of 26.5 consultant posts: approximately 5 of those are specialists in paediatric allergy. It is frequently argued that the lack of NHS allergy diagnosis and management pushes pe...

Food Allergy and Intolerance Tests: YorkTest Gives Evidence to the House of Lords

Breath Spa for Kids — Fri, 16 Mar 2007 17:47:00 +0100

And please let Shinga hear some decent testimony before she explodes.Dr. Glenis Scadding is a consultant allergist with an fine reputation. She has clearly and elegantly stated that IgG tests for the diagnosis of food intolerance are "a waste of money". She has criticised the availability of direct-to-consumer IgE tests because they lead to "mis-diagnosis and mis-allergen avoidance".However, at the same hearing where Dr. Scadding spoke, and earlier in the session, Dr. Hart, a representative of YorkTest, gave evidence at a meeting of the House of Lords, Science and Technology SubCommittee hearings that are investigating allergy and allergic disease in the UK.In summary, Dr. Hart acknowledged that IgG levels are not necessarily related to either food intolerance or chronic conditions. She al...

IgG Tests Are A Waste of Money: House of Lords Committee Hears Evidence, Let's Hope That They Listen

Breath Spa for Kids — Thu, 15 Mar 2007 14:55:00 +0100

I think that IgG tests may accurately measure IgG levels but I do not believe that there is scientific support to confirm the relevance of IgG levels in the diagnosis of food intolerance. I have stated this in several posts over the last few weeks (see list at foot of post).Today, the House of Lords SubCommittee that is looking into allergy and allergic diseases in the UK heard Dr. Glenis Scadding, Consultant Allergist of the Royal Nose, Throat and Ear Hospital, state this in a far more succinct and elegant fashion. My draft transcript of the full exchange from today's meeting (audio recording: available for 28 days and thereafter in transcript form) follows but the highlights from the redoubtable Dr. Glenis Scadding are:What I do dispute is that it is worth making any attempt to identify ...

Allergy and Intolerance Under Scrutiny by House of Lords

Breath Spa for Kids — Fri, 09 Mar 2007 14:07:00 +0100

The House of Lords has a Science and Technology Committee that is one of the main investigative committees in the UK. The Committee is a major forum of independent expertise and its broad remit is “to consider science and technology”. The S & T Committee investigates a range of topics including those with public policy implications and assessing health and research priorities. Committee recommendations are largely directed at Government, though they may also have implications for industry, the professions and consumers and the general public.Presently, Sub Committee 1 is investigating allergy and allergic diseases and their associated range of policy issues. However, because allergy service provision was recently examined by the House of Commons Health Committee and the Department of H...

Food Intolerance Testing and Migraine

Breath Spa for Kids — Tue, 06 Mar 2007 10:52:00 +0100

I have seen some extravagant claims about the value of food intolerance testing in reducing migraines, e.g., An appetite for migraine?. Barbara Lantin sums up the findings of a (then) recently released study by Rees, Watson, Lipscombe, Speight, Cousins, Hardman and Dowson:In the first study of its kind, 61 people with moderate to severe migraines were given a food intolerance test. Only one patient had no intolerances at all and the average participant had 5.3. Of those who eliminated the named foods from their diets, 80 per cent reported some improvement in their migraines and more than a third reported significant relief. More than 60 per cent of patients who reintroduced the suspect foods into their diets reported the return of their migraine symptoms.That is one interpretation of the p...

Truthiness and Referenciness Make the Case for IgG Food Intolerance Tests

Breath Spa for Kids — Sat, 03 Mar 2007 12:22:00 +0100

And please let Shinga read some decent research papers before she explodes*.Prof. Ernst has frequently and elegantly rebutted the claim that CAM treatments and therapies are not amenable to standard forms of scientific investigation. However, hand in hand with the claims that CAM is not suited to scrutiny, it seems that there is a certain truthiness and referenciness that predominates in the claims of scientific support for some of these treatments.Dr Ben Goldacre, used this word to suggest a supposed scholarly reference that wasn't a real one: "The scholarliness of her work is a thing to behold: she produces lengthy documents that have an air of 'referenciness' ... but when you follow the numbers, and check the references, it's shocking how often they aren't what she claimed them to be." ...

More Allergy and Intolerance Testing Nonsense: Part 2

Breath Spa for Kids — Thu, 01 Mar 2007 17:13:00 +0100

Allergy Magazine has recently published a feature on DIY Diagnosis. There is a reasonable introductory summary about the difficulties of gaining access to allergy diagnosis and management on the NHS. There is the usual sloppiness about referring to allergies and intolerance as if they are synonymous. The author uncritically reproduces a number of claims that are frequently repeated but I have yet to see substantiated:[h]aving an allergy is now one of the most common health complaints in the UK, affecting an estimated 23 million people and four out of ten school children. Up to 40 per cent of the population are sensitive to the three most common allergens: dust mites, pollen and pets. Millions more are intolerant to certain foods, most commonly wheat and dairy.There is the usual pop quiz wh...

More Allergy and Intolerance Testing Nonsense: Part 1

Breath Spa for Kids — Thu, 01 Mar 2007 13:42:00 +0100

Recently, I commented on Hardman and Hart's recently published audit of YorkTest's IgG-guided food elimination diets and chronic medical conditions. Although the survey was sponsored by Allergy UK it is a poor study that does not provide enough detail to be able to evaluate either its conclusions or its publicity. I had hoped that the study was so self-evidently incapable of supporting swashbuckling or grandiose claims that people who profess an interest in decent science or a reputable evidence base would not over-state its significance.YorkTest has published a summary of some of the paper's findings that make substantial claims about its significance and criticises the NHS: 10 Years of NHS treatment and still we're ill says study. I must reiterate at this point that the survey does not i...

Quote Mining and Misrepresentation: Poor Ways to Claim Clinical Validation or Sound Science

Breath Spa for Kids — Tue, 27 Feb 2007 15:15:00 +0100

This study is very poor; the claims being made for it are over-blown and disproportionate. Readers can not possibly assess these claims of NHS mis-treatment or mis-guided treatment if we have no way of discovering which treatment modalities were attempted.YorkTest also has the chutzpah to promote an obscure petition to provide free food intolerance tests on the NHS. Their pious hope is that the petition:re-enforces the view that the NHS should put peoples health at the forefront of its health service strategy. If the petition takes off, then it could make the health minister sit up and take action in saving the health service thousands of pounds whilst freeing up doctors valuable time. At best this petition might make the stakeholders of the health service to look at what is best for the p...

What is the Significance of IgG Antibodies and Testing?

Breath Spa for Kids — Mon, 19 Feb 2007 15:41:00 +0100

I recently highlighted my misgivings about the claims of sound science or clinical validation for IgG testing for food intolerance. Dr. de Asis gives a very helpful and clear overview of food allergy, intolerance and testing. Similarly, Dr. Minocha offers an fine overview of food allergy and tolerance.I thought that it might be helpful to quote the position of some professional organisations on the topic of IgG significance and testing.The American Academy of Allergy, Asthma and Immunology commented on the significance of IgG anti-allergen antibodies in September 2006. They observed that a number of commercial labs claim to be able to measure IgG antibodies against common substances: they questioned the clinical significance of the findings. Although this piece probably refers to labs in t...

Why IgG Testing for Food Intolerance Is Not As Simple As ABC or Doh Ray Mi

Breath Spa for Kids — Fri, 16 Feb 2007 12:18:00 +0100

What I know about the scientific validity of IgG testing to diagnose food intolerance could be written on a postcard leaving plenty of room for the address and stamp. I'm just mentioning this because it may be time for authors' competing interest declarations to be supplemented with a statement of scope of knowledge/ignorance/belief. I've been prompted to consider the need for this statement by Patrick Holford's theatrical outrage about BBC Watchdog's Dirty Allergy Trick* (NB, the original article has been removed, I shall do my best to keep up with other links to it). A healthy volunteer participated in three food allergy/intolerance tests – two VEGA tests (conducted at different times and with different operators), a hair test, and two YorkTest IgG Food Intolerance tests (he submitted ...