tonysci

OK, I'm back again with more labs: IgG2 again elevated (slightly) DHEA-S: elevated (slightly) Testosterone, SHBG, AM Cortisol, TSH, free thyroxine & free T3, HGA1c all within reference.

CBC and diff all look quite normal. Neutrophil count around 4000 and sed rate = 1. Retest of subclasses, tests for hormone levels (cortisol, testosterone, thyroid panel) are aready underway. Thanks for the help thus far...

Thank you for the reply. I thought I had stumped everyone! The test was done as part of a workup for idiopathic fatigue. Subclass elevation was not what we expected to find. Deficiencies have been found in some studies of CFS. The next logical step would be to identify what is driving the elevation. The only clinical test I know of for endotoxin is the LAL, which is supposedly unreliable. I'm not sure where that leaves us. It's not realistic to test for all polysaccharide producing infections. We need to narrow it down somehow, but I don't know of any way to do this that is clinically feasible.

I am trying to explain the following IgG subclass distribution: IgG1: low normal IgG2: ELEVATED IgG3: low normal IgG4: normal I understand that IgG2 is targetted primarily towards LPS antigen, which is the product of gram-negative bacteria. What I do not know is whether there is any other explanation (such as Th1/Th2 imbalance) that could account for the this distribution. Is the pattern a reliable indicator of gram-negative bacterial infection? Lacking any distinguishing symptoms, is there any way to ID the species behind it?