posted
CD 57 - I hear mixed things about usefulness of CD57. I was recently dx w Lyme and just received CD57 results of 82. I know Dr Burrascano states "When this test is run by LabCorp (the currently preferred lab, as published studies were based on their assays), we want our Lyme patients to measure above 60; a normal count is above 200." I am way below 200, but Perplexed by what he meant by wanting his Lyme pts to test above 60. Does he mean it can be easier to treat patients above 60? Wondering what he meant. Thanks.
Posts: 138 | From Connecticut | Registered: Dec 2012
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CD57
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posted
This test is out of vogue and not being used much anymore. My doc will use it to confirm infection but does not use it to direct treatment. He has found that very sick folks have high CD57 and very well people have low CD57, so doesn't correlate.
Posts: 3528 | From US | Registered: Apr 2007
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TF
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posted
I think Burrascano just meant that the reference range of the CD57 score is 60-360. So, if the patient is above 60, they are technically in the reference range.
(I don't take comfort in a score of 60 since I believe the "reference range" likely includes many people who have lyme and don't know it, have HIV and don't know it etc. My lyme doctor believes that if doctors tested all of their patients for lyme, they would be surprised how many positives they would get.)
The fact that Burrascano says "a normal count is above 200" tells me that you want 200 to be the bottom of the normal range--regardless of the reference range. You want a LOT of T cells to show up in your blood, like a normal healthy person has.)
If you look into the concept of "reference range" I think you will find that it includes about 90% or more of the population (all scores within 3 standard deviations from the mean). In other words, the reference range is built on the results of the vast majority of the population when given the test. So, if we have a pandemic of undiagnosed lyme--which we do (and which lowers the CD57 score), it makes sense to me that many of these folks have low CD57s. The medical laboratories see lots of scores in the 60s, 70s, etc. and therefore assume that these scores are normal. They see so few scores below 60, percentage-wise, that they decide a CD57 of less than 60 is an indicator of an abnormality.
Little do they know that there are so many terribly sick people that doctors are classifying as NORMAL.
We have the same situation with the Vitamin D reference range. Doctors now routinely tell patients that they don't want their Vit D score to be in the lower part of the range. That part of the range is now recognized as not optimum. Many labs have even added a note at the bottom of the test results telling the patient and doctor that.
Burrascano definitely doesn't mean that it is easier to treat people whose score is above 60. There is no indication of such a meaning in the paragraphs on this subject.
The Guidelines say that the CD57 is an indicator of how active the infection is. The trouble is, the score bounces around a lot! You will see that in the Guidelines also. So, you can't take comfort in just one score of 60. If you had 15 CD57 tests and all of them were above 60, that could perhaps be a small source of some comfort. The trouble is, the CD57 score does not correlate with how sick the patient feels!
When I had the CD57 test done (Jan. 2004) the ref range was 60-360. My score, after basically 2 years of amoxicillin treatment only, was 22. I felt pretty good, was working daily, etc. But, if I stopped the amoxi, I was a basket case in 2 weeks.
As stated above, since 2008, many lyme doctors have decided that this test isn't that valuable. So, this section of the Burrascano Guidelines may need rewritten. (Since Burrascano has retired, it won't be rewritten.)
It is still a good indicator of lyme disease when the score is well below 60, as in my case.
So, if a person tests negative for lyme, but has a very, very low CD57, that tells a lyme doctor that they likey really DO have lyme disease.
From page 8:
"Chronic LB infections are known to suppress the immune system and can decrease the quantity of the CD-57 subset of the natural killer cells. As in HIV infection, where abnormally low T-cell counts are routinely used as a marker of how active that infection is, in LB we can use the degree of decrease of the CD-57 count to indicate how active the Lyme infection is and whether, after treatment ends, a relapse is likely to occur.. . .
There generally is some degree of fluctuation of this count over time, and the number does not progressively increase as treatment proceeds. Instead, it remains low until the LB infection is controlled, and then it will jump. If the CD- 57 count is not in the normal range when a course of antibiotics is ended, then a relapse will almost certainly occur."
So, I would say not to read anything into your score of 82 except that it indicates your immune system is weakened. If your score were normal, at least 200, then you might question the diagnosis of lyme since you have been sick for much more than a year (the point at which the immune system usually reaches clinically significant breakdown--see page 3 of Burrascano).
Posts: 9931 | From Maryland | Registered: Dec 2007
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CherylSue
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posted
Thanks, TF, for explaining this. After 5 years of treatment, my CD57 keeps dropping although I am feeling much better. My LLMD wants it over 140 (Lab Corps).
When I had a relapse in April 2011, my CD57 from Quest was 125. My current LLMD doesn't use Quest for testing the CD57. He uses Lab Corps.
Posts: 1954 | From Illinois | Registered: Aug 2007
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posted
Thank you very much. On another note, recall you saying you had no improvement on 2 yrs amox. Just was confused. Again, thank you. U have helped me tremendously this week and I am forever grateful
Posts: 138 | From Connecticut | Registered: Dec 2012
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TF
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Member # 14183
posted
lymelisa, I had some improvements on amoxi only for 2 years. See my second post to you on Jan. 15 in this thread where I state that:
For example, the horrendous fatigue lessened after about 6 months on amoxi only. That was wonderful.
Posts: 9931 | From Maryland | Registered: Dec 2007
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posted
Does anyone remember seeing the recent ILADS conference where one of the presenting docs said that LabCorp is no longer the go to Lab for CD57...something about they have changed their testing (??) .....I think the dr presenting said Quest is now the go to lab for it (??) Did anyone else see or hear that? I only saw part of the presentations and it was a bad day for me.
Hoping to get clarification from a more clear mind about it. Anyone out there? Thanks:)
Posts: 495 | From SF Bay area, CA | Registered: Dec 2007
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ktkdommer
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posted
My doctor was at the conference and wrote out labwork for CD57 through LabCorp. I would like to know more about this comment.
My doctor did say that often the CD57 number doesn't spike up until the very end of treatment. The three of us have all improved over the duration of our treatment. Still not where we need to be though, but our numbers indicated an improving immune system and one not so affected by Lyme anymore.
-------------------- Things are never dull. After 3 fighting Lyme, 2 are in remission. Youngest is still sick, age 22. He has new diagnosed Chiari Malformation and Ehlers Danlos Syndrome. Posts: 1366 | From Perrysburg, Ohio | Registered: Nov 2010
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posted
I am pretty sure, but not certain, thatit was DrH or DrB who made the comment. I just can't be sure about it, which is why I am here asking here. It was at the recent ILADS conference presentations so just weeks ago.
I have a lab order to get it checked to see where things are at this point and wanting to make sure I am dealing with the right lab for it. I had it written for LabCorp and Quest so I am set for either one. In retrospect, all my prior labs on this were LabCorp so despite the uncertain comment about it I think I will go with that one since the purpose is comparing to my prior labs which were LabCorp. Sorry for the confusion. Hopefully we can learn more about this for others.
Posts: 495 | From SF Bay area, CA | Registered: Dec 2007
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gigimac
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posted
I believe my doc ordered a cd57 (haven't gotten the blood drawn for it yet) from igenex. Is that not a good lab for cd57 and should I ask her to change it?
Posts: 1535 | From Greensboro NC | Registered: Aug 2011
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