Help understanding results

[Scootermom]

Hi,

I wonder if I could get some help reading my APA panel results?

I know they're abnormal and my fertility consultant has advised I'm treated as he would someone with Hughes syndrome but he said I don't necessarily have it.

I've suggested to him that I re-test within the 12 weeks to determine if I do or not and although he initially said there was no need as his treatment for pregnancy was the same, I explained that I thought it would make sense to do it now rather than having to repeat the tests twice more.

So he's happy to do this. This communication was over email so I haven't really had a good conversation with him yet.

Some of the reading I've done mentions that 3 things are tested for Antiphospholid Syndrome:

Lupus anticoagulant

Anti-cardiolipin

Beta-2 glycoprotein I (B2GPI)

From looking at my results, I only see that the Anti-cardiolipin was tested. Is this sufficient?

Also after my initial miscarriages years ago, I had several standard tests done and I tested fine for Anti-cardiolipin and Beta-2 glycoprotein.

IgG anticardiolipin Abs. 3 U/ml (0-10)

IgM anticardiolipin Abs. 4 U/ml (0-7)

Anti beta2-Glycoprot.abs 2 U/ml (0-8)

What does this mean, have I since developed the antibodies, I had 2 miscarriages prior to that testing and I've had another 2 since. I have one son that I had no problems with in pregnancy prior to all this.

At the time, I had heard some consultants were prescribing baby aspirin but my consultant from then said that more recent reports indicated that unless one needed it shouldn't be prescribed and she was hesitant to as my blood flow was high.

PT 14.1 SECS. H (11-13.5)

INR 1.2

APTT 35.5 secs. H (23 - 33)

APTT 35.3 secs. H (23 - 33)

Fibrinogen (der.) 3.2 g/L (1.8 - 3.6)

Is this a concern for having IVIG, prednisone or lovenox? These were mentioned by my new consultant as possible treatments during IVF.

And lastly, probably a silly questions but does each time I'm pregnant raise my antiphospholid antibodies? What causes them to raise?

Thanks so much.

[MaryF Administrator]

Hi there, there are no reference ranges with this, and please, it is not the safest way to proceed doing this on line. I suggest a visit to one of the specialists on our list: On the charity website, you could try for an emergency appointment privately, it is vital that you have some one to one care face to face. MaryF x

[Manofmendip]

I agree with my colleague Mary.

We are not medical professionals and are not in a position to advise you on this.

Let us know how you get on.

Dave x

[Scootermom in reply to Manofmendip]

Ok thanks. I'm going to find a rheumatologist in Ireland. I needed to decide whether to repeat the test with my reproductive immunologist or not but I think that perhaps the tests a rheumatologist will run might include Lupus anticoagulant and Beta-2 glycoprotein I (B2GPI) and not just Anti-cardiolipin which might be better.

[momtomany]

The only abnormal test I recognized was the acl IGM. I would assume you need a retest based on that result alone, since you had moderate antibody levels. You do not need to test positive on all 3 to be considered positive. As long as one is positive twice at least 8-12 weeks apart you are considered to have APS (along with a clotting episode or miscarriages).

Please note I am merely a patient attempting to help, and I agree that you should seek appropriate medical consult.

[momtomany]

I just reread your post. The antibody levels rise and fall depending on whether we are in an active flare. It is possible that you tested negative and now have antibodies. That is why the secondary test 12 weeks apart is the standard protocol.

I cannot tell you if you indeed have Hughes, but it certainly warrants further investigation.