Inquiry Regarding Specific Antibody Deficiency (SAD)
Greetings! While I can't encapsulate my entire medical history in this singular message, I do have a pertinent question I'd like to present. Concerning Specific Antibody Deficiency, my diagnosis was made when I turned 11. It’s worth noting that I have faced ongoing infections since the age of 6, with a predominant occurrence of streptococcal and sinus infections. Moreover, I've experienced episodes of autoimmune encephalitis linked to my illnesses. When I was 10, my physician ran tests on 14 different strains of streptococcus pneumoniae, revealing that I had deficiencies across all of them. Despite having completed the full series of the Prevnar vaccine as a child, this deficiency remained unexplained. At the same time, I was found to be low in IGG3, although my other immunoglobulin levels (IGG, IGM, IGA, etc.) were reported as normal. At the age of 11, I received the PPSV23 vaccine, which resulted in a positive outcome upon retesting; my antibody counts had risen. However, within a span of 12 to 18 months, I noted a drop in my levels once again. Subsequently, when I was 13, I received the PCV13 vaccine but unfortunately had a severe reaction that resulted in prolonged neurological symptoms for an entire year, along with a resurgence of autoimmune encephalitis. Following that, I was approved to begin IVIG therapy. Once more, approximately a year and a half post-Vaccination with PCV13, my antibody levels fell short again. Thus, my concern revolves around the diagnostic process for SAD. According to the criteria, to qualify for the memory phenotype diagnosis, a loss of immunity must occur within six months. My own experience shows a decline in immunity occurring roughly between one and one and a half years after receiving vaccinations. I had been under the impression that these vaccinations were supposed to confer lifelong immunity, yet I have already undergone five doses and am facing deficiencies once more. Could this indicate that I have SAD, or is it simply a reflection of an underperforming immune response?
Answers (1)
3/18/2025, 9:50:38 PM
OpenHealth AI
Thank you for sharing your detailed medical history regarding your experience with Specific Antibody Deficiency (SAD). Your situation is complex, especially after dealing with recurrent infections and complications from vaccinations. Let’s break down your concerns and clarify some important points.
Main Points
- Diagnosis of SAD: Your history of infections and the response (or lack thereof) to vaccinations raises valid questions about your immune system.
- Vaccination Response: The lack of sustained antibody levels after receiving vaccines could indicate an immune deficiency.
- Further Investigation: Understanding the decline in immunity and relating it to SAD necessitates further exploration and discussion with your healthcare provider.
Explanation
Specific Antibody Deficiency (SAD) is characterized by an inability to produce adequate antibody responses to polysaccharide capsules of bacteria, despite having normal levels of immunoglobulins. It is concerning that you've experienced repeated infections and a troubling response to vaccinations, especially if your immunity significantly declines over time.
The criteria for diagnosing SAD include:
- Recurrent infections due to encapsulated organisms.
- A specific deficiency in antibodies to polysaccharide vaccines (like pneumococcal vaccines) within a timeframe as described in the SAD guidelines.
Your observation about a drop in antibody levels long after vaccination is important. While typical vaccine responses can provide lasting immunity, individual variations exist. This includes potential immune dysregulation, which may explain why your body struggles to maintain antibody levels.
Next Steps
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Track Your Symptoms and Immunity: Keep a detailed record of your infections, vaccination dates, and any treatments received, including IVIG therapy. Note how your body has responded over time to these vaccines and treatments.
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Consult an Immunologist: Given your history and concerns, it would be beneficial to revisit your immunologist or seek a second opinion from another specialist. You may want to discuss:
- Further testing to assess your immune system's function, especially how it responds to specific pathogens.
- The possibility of reevaluating your SAD diagnosis in light of your vaccination responses.
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Discuss Management Strategies: In collaboration with your healthcare team, explore potential adjustments in your management strategy, including the role of IVIG therapy and its frequency. If your antibody levels continue to decline, alternative treatments or additional vaccinations may be necessary.
Feel reassured that your experience is valuable for understanding your immune system, and proactive steps can help manage your condition. Please keep tracking your symptoms and advocate for yourself during medical consultations. If you have any further questions or concerns, feel free to ask!
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