High CD3 Counts and high IgG - overactive immune system?

[Letitgo1989]

Hi,

Have an appointment with an immunologist re: high cd3 counts. Results below.

Absolute lymphocyte count: 3000
Cd3: higher than reference range
Cd4: 1620 (600-1700)
Cd8: 800
Cd8/cd4 ratio: 1.9

Immunoglobulin G: 18.5 (6-16)

Hiv is negative. EBV positive. CMV igm positive. Doctor doesn’t think it is Leukemia, lymphoma or anything sinister. What could this be?

[Letitgo1989]

CMV igg positive - not igM.

[Ken_PA]

Hi, have they discussed "chronic EBV"? That can also give a false positive for CMV.

CD3, CD4 and CD8 are found on  "T-cells", which have as one of their jobs the killing of your own cells that have become infected with a virus (and also killing cancer cells).

Immunoglobulin G is made by B-cells, at times to attach to and neutralize viruses. But the immune system can get infinitely more complicated.

There seems to be something puzzling to them because you've had some fairly advanced tests. Is it that this has been going on for quite a while?

[Letitgo1989]

I had acute EBV / mono three months ago. My immunologist thinks the results could be “unremarkable” but also wanted a second opinion on here. Chronic EBV has been discussed but after 4 months my igm for ebv has returned negative so that’s been taken out of the equation.

[Letitgo1989]

Only cmv igg was positive.

[Ken_PA]

Well, just in case you aren't familiar (but you probably are): IgM is like the first prototype antibody, then after some trial and error, the improved IgG Ab's are custom manufactured en masse.

"Only cmv igg was positive."
Okay, that's the curious part then. Maybe your custom manufactured Ab's are not typical, and their binding ends (Fab portion) are configured so that they like the CMV more than the EBV? Just speculating. That'd be something like an error in the "class switching" process. EBV and CMV can have very similar little segments (epitopes).

Btw, offhand I don't know of any way that cancer can give all these various results together. But they have to at least consider cancer, because missing it would be disastrous.

[Letitgo1989]

They have sent me to an immunologist who is running a leukocyte phenotype. I am a bit scared

[Ken_PA]

If your mono was especially ferocious, that could point to an overactive immune system, IMO.

[Letitgo1989]

I was tested for hepatitis a, b, c all negative. Only HBsAb came to >1000 which apparently means full immunity by vaccine or prior infection?

I don’t recall ever having Hep B or a vaccine. It could’ve been when I was a child. Could I still be infected with Hep B even though the HBsAg is negative / non reactive

[Ken_PA]

Sorry, I don't know anything about hepatitis and what patterns to expect.