Post 4th LIT consultation

Yes, I remember it clear. HLA class 1 is HLA-A, HLA-B, HLA-C ... While HLA class 2 is HLA-DR, HLA-DQ.... Lost in translation. Where did I arrive at this explanation: HLA column1 is from husband and another column is from donor?  Grrrr.... Those secretaries and fellow patients were feeding me with the wrong info. I asked doctor again today: what is the LAT-M columns about. Wahaha... He said I better enroll in his immunology class. Who am I talking to? I said never mind... He asked again: who? wahahaha his secretary :(

I need to have another LIT next month. That will be my 5th LIT. Did I had another bout of infection? My immune system was very active or by coincidence? Majority of the patients just had 4 LIT prior to conception. Comparing the four session, my induration was getting bigger each LIT session. And I had developed pustules again. After the fifth LIT, I will be sending my blood abroad from testing again.

My uterine biophysical ultrasound result says my uterus echogenecity was course. Uterine NK cells were responsible for destroying the smoothness of my uterus muscles. Calcium deposits... The coarse texture affects the implantation success.

Endometrium layer blood flow... What was it again? I forgot... I was tired and sleepless. I went to the clinic at 4am... I remember the explanation was NK cell are causing the scar again. Restricting the blood flow and thinning the uterus.

How bad is the picture of my uterus? Why not just try to have a pregnancy work up? He showed me his worksheet of my induration sizes after each LIT. My immune system will prevent the implantation. Poor shel!

My impression is my Nk cell is causing scars and permanent damage to the uterus and endometrium.

Question: how bad is my uterine NK cell? How does my peripheral blood Nk cell correlate with my uterine NK cell? My peripheral blood NK cell is just boundary level with no killing power. Is there a way to test the toxicity of my uterine NK cell? Answer: it is impossible to test the uterine NK cells. Not unless I am an animal, he can cut and slice...

4th LIT

Tomorrow is my fourth LIT. Why I am resisting it in the past? Misdiagnosis, and blood products risks... I somewhat feel like a guinea pig.

Now, I feel my reaction code is 8-8 already, because my husband need not to donate blood tomorrow. I am quite doubtful. Last test it was just 6-4.

My uterine biophysical ultrasound

I got a profile score of 16 in the uterine biophysical ultrasound. It says the conception rate is 60%. I don't know whether I should be happy or not. After getting the report, I smiled at the sonologist and thanked him. He then asked whether I have tried ivf. Why did he asked that question? I can't help but to think that 60% is not a good score. Whatever.... I guess my score will improve by blood thinners.

I also had my LAT-M done today. Let's see.

Two schools of thoughts: Lymphocyte immunization therapy

What if I had LIT solely on husband's lymphocyte? What if, we share many HLA antigen in common? I will not produce antibody against the common HLA. If I and my husband share many HLA antigen, chances are after 10 x of LIT with husband's lymphocyte the reaction code remains unchanged. Am I correct? What is more important- the reaction code between or the panel reactive antibody score? I guess I don't need to have a positive reaction in each of the serum from the panel reactive antibody. I need positive reaction to my husband's lymphocyte only. Immunologist wants 100% score because they feel high PRA is safe?


Oh, two school of thoughts. First, husband as the sole donor. Second, unrelated donors + husband.

I trust my watch 100%. I wear one watch only, or never at all.  Wearing two watches is quite confusing, if both are not synchronized, I don't know which is telling the correct time. It defeats the purpose of wearing a watch. Wearing three watch will be acceptable but quite odd. The logic here is majority wins. Wearing 4 watches is funny. 

And... what about my immunologist protocol on the number of donors? Why husband + 3 unrelated donor? My immunologist also wears three watches? He is not happy to wear one watch? Why not 7 donors at a time? I have 3 unrelated donors on first LIT, and another set of 3 unrelated donor on second LIT + husband= 7 donors total? Why not do it together?

"Dear Obgyne,
... She is responding slowly to the LIT. Most likely they share more than one HLA antigens in common...
Regards,
Immunologist"

It is betting time! what will be my reaction code 8-4 , 8-6 , 8-8 or 0-0 on my next LAT-M IgG test? Winners will receive surprise gift.

Back to my very old sentiment... my husband has erectile dysfunction. Limited exposure to sperm creates limited antibody. Therefore I failed in the LAT-M IgG test. I contested I don't have immunologic problem. I don't believe in the PRA thing.

My third LIT consultation

Doctor said my I have developed pustules against all donors, lymphocyte. This maybe viral infection. Yes, I have colds. Virus and bacteria makes our immune system to be active.

My base line for the reaction codes: 2-2. It has jumped to 6-4. The bad news is I slowly respond to LIT.  Ideally, the reaction code should be at the same. My induration from husband lymphocytes are smaller. He concluded that we share at least one common HLA.

Btw, what is LAT-M IgG? It measures the anti-HLA antibody. How can I be sure the my body will produce anti-iditotypic antibody after I have produced the anti-HLA antibody. Doctor said it definitely will. Anti-idiotypic antibody stops the production of rejecting antibody (anti-HLA antibody). Its function is to bind to anti-HLA antibody. Otherwise, my anti-HLA antibody will reproduce without limit.

What is PRA? What does it have to do with pregnancy? I don't believe much in PRA. There are cases wherein the father had raped his daughter. And they were able to bear a child. I feel blocking antibody is not a necessity to get pregnant. My fetus will be safer if I don't produce blocking antibody against my husband. Doctor said re: father raped daughter case. After the daughter has given birth, definitely she will have high level of blocking antibody against her father. Our body is programmed to distinguish our own cells from cancer cells, bacteria, etc... It is the function of ourmy immune system to restrict the unnecessary growth. Oh my god! My PRA theory is defeated.

I had a very long story of latent tuberculosis, what if my donor has latent tuberculosis? No medical and scientific studies show that latent tuberculosis can be spread through blood donation.

He requested for a uterine biophysical profile to see whether I have enough blood flow to the uterus at the time of ovulation. This affects the implantation success of ivf.

P.S. Doctor said don't get pregnant.

My blood safety questions

These questions popped up the yesterday while I was doing my lymphocyte immunization therapy:
1. People with latent tuberculosis may get positive in the skin tuberculin test. What is responsible for the skin sensitivity test? We are expecting for a delayed type hypersentivity reaction, correct? So, are we checking for its T-cell? Hmmm... T-cell is a white blood cell.

2. What if the donor has latent tuberculosis, can pulmonary tuberculosis spread through blood transfusion?  I believe Philippines belongs to the top 10 countries with the most incidence of tuberculosis cases. But my doctor assured me tuberculosis bacteria cannot be spread thru blood transfusion.

3. What if my donor had undetected autoimmune disorder? I have read some articles say having HLA-B27 gene does not necessarily mean that you will get spondyloarthropy. Why is it so? I guess because there is no HLA-B27 antibody to react with the surface antigen of the host cell. Therefore no inflammation. What if the donor has undetected rheumatoid arthritis? This entails I will produce HLA-DR4 antibody. Do I know my genome sequence? If I dont have HLA-DR4 gene, it will not affect me. What if i have that gene, then it will trigger my autoimmunoty. Correct?

4. Prions are not also included in the blood screen.

5. Are there other infections that can be spread thru blood transfusion? I am referring to mycoplasma and other curable bacteria infection that is not included in the standard blood screening test.

My third LIT- giant pustules

I feel febrile and little throbbing pain on the injection sites. I thought I have developed immune tolerance. After 8 hours, I saw 14 out of 16 injection sites developed pustules. They were bigger than the first LIT. I thought I will be graduating from lymphocyte immunization therapy in no time. Now, I feel not febrile anymore.

I said in my previous post, Anti-idiotypic antibody may compete with my donor's HLA in the binding site for anti-HLA-antibodies. Anti-idiotypic antibody halts antibody production. Ei, Did it just enhanced my immune activity? Anti-idiotypic antibody triggers the production of anti-HLA antibody. Hehe looping! Donor HLA triggers the production of anti-HLA antibody. Ergo, it has additive effect. Wahaha, my stilly theory.