Blood Results are in can't see a doctor for months...help!

[journey2joy07]

After multiple miscarriages (from IVF cycles), my Reproductive Endocrinologist ordered the miscarriage panel.  My results are in...and I am so confused.  Hoping someone can help me understand what is going on with me and give any advice possible as the earliest I can see a rheumatologist is September.  Thank you in advance!!!

My abnormal results:

- ANA Screen, IFA- Positive

-Inhibitor (PAI-1) Out of Range- 64 H   (reference range 4-43)

- Sjogren's Antibody (SS-A) 2.3 Positive
                                 (SS-B) <1.0 Negative

[SjoAmy]

A positive ANA (Anti Nuclear Antibody)  gets reconfirmed by the presence of your SS-A Antibody.  That's not too bad a level ( mine is 8 ).  But SSA is also known to be present with other autoimmune diseases like Lupus & Rheumatoid Arthritis, but it IS a Sjogren'santibody.   SSB is another Sjogren's antibody, supposed to be more specific for Sjogren's......but as you will see, plenty of people get diagnosed with just SSA (like me). And then there are the "sero-negative" people.....they don't have either antibody but have plenty of symptoms.

Be CAREFUL.....SSA is known as Anti-Ro.....that is NOT a friendly antibody for the unborn child.  Talk to your OBGYN.  That antibody is also related to nerve damage.

I would ask that you ask your doc for a Rheumatoid Factor test.  Just to be sure your autoimmunity doesn't have friends.  Anti-thyroid antibodies & TSH too....if your thyroid isn't functioning for one, it will have a hard time functioning for two.

Check to see if you & the baby's dad have corresponding Rh .   They used to call it bad blood in the old days.....Rh - blood shouldn't mix with Rh + blood.  A miscarriage could be nature's way of saying  "I can't work with these two blood types!"

[Linda196]

While I agree completely with what has been said, I think your immediate concern is the Inhibitor (PAI-1). Plasminogen activator inhibitor-1 is part of the body's clotting cascade, and an increase can result in clotting or, more significantly, thrombin deposits in the placenta, sadly resulting in miscarriage.

A statistical study in 2005 (Glueck and colleagues (Metabolism 2005;54:1345-9)) found

that "PAI-1 activity was positively associated with first-trimester miscarriage (p = 0.004)" ... and "for each 5 IU/mL increment in PAI-1 activity, the risk being in an adverse first-trimester miscarriage ...increased

There is also data to support increased problems with IFV, either failure to implant or to carry.

I've only seen anecdotal results about treatment, but the standard blood thinner treatments, administered under strict control, seem to have the same success in carrying to term as they do in patients with anitphospholipid syndrome.

The SSA (anti-RO) is a concern because of the potential for the baby to develop neonatal lupus or congenital complete heart block, but since you are already seeing a specialist, he or she will be aware of those issues and will monitor appropriately, I'm sure.

[Carolina]

Dear  journey:

I can't help you at all with your numbers or your long wait.

My heart goes out to you and I know you've come to a very helpful and kind group of people for support.

Keep us posted, and keep breathing.

Hugs

Elaine