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What Does The Following Blood Test Reports Indicate?

Posted on Fri, 17 Jun 2016

Question: Hi
My wife is now 10 weeks pregnant as on today - 03/05/2016. We did first blood work in 8th Week, and her Rubella Igm test came out positive with high values and IGG came just above XXXXXXX limit and IGG avidity also slightly above high limit.
We got multiple tests done from 2 different labs, and all relevant reports are attached.

We are not sure, should we terminate the pregnancy or there is chance we can continue. Currently our doctor has advised to wait 2 more weeks and do rubella Igm & Igg tests again to see rise in Igg values.

But we are so much confused, and in doubtful situation.If igg values XXXXXXX in 2 weeks, i think we should terminate due to primary infection but what if Igg does not rise and remain same, can we be sure, there will be no risk of rubella while Igm is so high.
And if this is not primary infection, then why Igg is not very high but just on border.
Also then IGG avidity is high which usually comes in few months.

(As per wife parents they don't recall if she got rubella vaccination but probably not).

All Reports
1) 1st test (igg & Igm) from Dr. Dang Lab on 17th April'16

IGG ® REACTIVE 11.0 ( 0 - 10)
IU/mL
IGM ® REACTIVE 3.03 ( 0 - 1.2)

2) Re-test (igg & igm ) from Dr Dang Lab and Igg avidity from Dr Lal lab - 23 rd April'16
(Dr Dang does not have avidity test)

IGG - 10.6 IU/ml (0-10 range)
IGM - 3.010 (0 - 1.2 range)
IGG Avidity - 49.2 % (< 30 low, 30-40 Equivocal, > 40 high)

3) Re-test (igg, igm, igg avidity) from XXXXXXX XXXXXXX hospital on 26th April16. - This was done as per our doctor recommendation since this hospital has best lab kit.

IGM - 3.13
IGG - 17 ( 15 positive).
IGG Avidity - 63% ( 60 high)

Answered by Dr. Dr. Soumen Patra (1 hour later)

Brief Answer:
Repeat those tests after 1 week. Need to terminate the pregnancy.

Detailed Answer:
Hello Dear,

Thanks for writing to us. I have reviewed test results thoroughly.

1) According to last 3 test results, both IgM & IgG are POSITIVE or REACTIVE. It indicates recent infection of RUBELLA. It can cause many congenital problem of growing fetus during first trimester.

2) I suggest you to REPEAT those tests after 1 week to check the values. If they are still increased, I suggest her NOT to continue this pregnancy as there will be several birth defect (like heart problem, vision problem or Cataract, Hearing problem, neural problem, growth problem etc) associated with rubella infection.

3) Termination of pregnancy is advisable in this case after consultation with her treating doctor. It will be more worthwhile.

Hope, I have answered your query. Wish your good health and take care.

For future query, you can directly approach me through

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Soumen Patra (30 hours later)

Re-tests done after 2 weeks as of today - 5th may'16
New values are:
Dr Dang Lab
IGM - 2.95 (0 to 1.2)
IGG - 8.9 (0 to 10)

There is no increase IGG (but slight decrease) after 2 weeks but IGM remains nearly same.
Can there be possibility of false IGM positive results reacting with other viruses?

Answered by Dr. Dr. Soumen Patra (38 minutes later)

Brief Answer:
Chance of false positive is quite low or nil.

Detailed Answer:
Hello dear,

Welcome back again.

1) You have done the Rubella IgM and IgG test repeatedly. Therefore, chance of false positive test result is quite LOW or NIL.

2) IgM test result is more valuable than IgG and it is still increased in recent test report also.

3) I suggest you to consult with your treating doctor to terminate this pregnancy to avoid future risk and complication.

Hope, it helps for your information. Good luck and take care.

Regards,

Above answer was peer-reviewed by : Dr. Naveen Kumar