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Enzyme levels, carrier testing, etc.

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Dawn M View Drop Down
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Post Options Post Options   Quote Dawn M Quote  Post ReplyReply Direct Link To This Post Topic: Enzyme levels, carrier testing, etc.
    Posted: 18/September/2007 at 7:42pm

Ugh!!  I'm stressed tonight and thought I'd come here in hopes that you all could share your expert advice/knowledge with me.  A couple weeks ago we had Dalton tested for Krabbes just so we could put our minds at ease that he didn't have it.  Well, I heard back from the Dr. today with some news....sort of.  His enzyme level was 11....so on the "low side of normal" she said.  Makinley's level at time of diagnosis was 3.9 with her blood (which is how Dalton was tested too..so the comparable #.  Her level was 1.9 with her skin biopsy)  Her Dr. seemed to think that this enzyme level, while it is definatley Krabbe diesease, is a milder form....that a more severe form would show a lower enzyme level.  So, Dalton's low enzyme activity caused her some concern, she said, that if Makinley has a "milder form" of the disease, does Dalton have a mild form also and is just asymptomatic at this point?  She wants to do some additional testing (more or less carrier testing to make sure he doesn't have both of the same mutations Makinley has and thus, the disease)  So, my questions......what enzyme levels have you guys had, both with your Krabbe kids and carriers?  If he is just a carrier but has extra low enzyme activity does this mean anything as to what we can expect later in life...would it cause any problems or concerns? 

I think that explains it.  Sorry if I sound scatter brained....I'm stressed.  I know you all know how that goes.  If there are any other questions of things I left out, feel free to ask.  Oh, Dalton just turned 3 years old.  And I don't know if this matters, but apparently Makinley has one mild mutation and one more severe mutation...whatever that means.  Jeremy and I don't know what our enzyme activity is.

Thanks so much, everyone.  Sometimes I don't know what I'd do without the wealth of info. I know I can turn to here.

Dawn
Mommy to Angel Makinley (9/19/06-12/22/07) and Dalton
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D'Anne View Drop Down
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Post Options Post Options   Quote D'Anne Quote  Post ReplyReply Direct Link To This Post Posted: 18/September/2007 at 11:28pm
Hi Dawn,

The testing for GALC enzyme can have different results when run by different labs, with different "normal ranges" and lows.  Jackson's testing is done by Dr. Wenger's lab in Philly (as was mine and Marshall's, and the babies').  In Dr. Wenger's lab, 0.4 is the low end of normal (Jackson's current level... his level at diagnosis was 0), and 1.5 (my level) is normal but in the carrier range (but could also be non-carrier).  Our girls were both 2.9 (they are non-carriers).   I have no idea what the units are. 

Since Makinly's level of 1.3 would indicate NOT having Krabbe disease if it were run by Wenger's lab, I'm assuming that your family is having the GALC testing run by a different facility with different ranges.  I'm not familiar with any other testing methods or units, so I can't really help you with that.  If the doctor is concerned about the possibility of Dalton having a late onset form, DEFINITELY get more testing done to find out for sure - he's a good candidate for transplant if he does have Krabbe but doesn't yet have symptoms.

Since Dr. Wenger is involved in the research for Krabbe and probably has the most experience in running the GALC assay, it might be a good idea to have him run the testing on Dalton.  He should be able to give you a very good idea of what you're dealing with and take a lot of the guesswork out of it for you and the docs.  It sounds like you all are dealing with some complicated issues, and having someone with lots of experience in interpreting the results could be very helpful.

Good luck, Hopefully Dalton is just fine.


Peace and blessings,
D'Anne
Mom to Jackson (late-onset Krabbe, transplanted 10/29/04) and healthy twin girls through PGD

http://www.jacksonwhite.com
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Melaniemac View Drop Down
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Post Options Post Options   Quote Melaniemac Quote  Post ReplyReply Direct Link To This Post Posted: 19/September/2007 at 2:18am

Hi Dawn, I've just checked our info on Jack and he was 0.6 at diagnosis (via blood tests), Scott and I were also tested but we were never told the numbers. (Im curious now so think i will phone them today to find out)

Im sorry to hear that you are even more worried now but i am sure Dalton will be fine.  I would definately contact the Doctors that are experienced in Krabbes, because you need peace of mind about this.

Hugs Melanie x

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Melaniemac View Drop Down
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Post Options Post Options   Quote Melaniemac Quote  Post ReplyReply Direct Link To This Post Posted: 24/September/2007 at 3:30pm

Hi Dawn, did you get any answers??? I asked for our levels and now i'm even more confused   as we are both lower than Jack.

I was 0.3 and Scott was 0.4

Is this normal for carriers???

I am going to phone our Doctor to ask him to expain as i am confused

i've also sent you a pm

Melanie x

 

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Dawn M View Drop Down
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Post Options Post Options   Quote Dawn M Quote  Post ReplyReply Direct Link To This Post Posted: 28/January/2008 at 7:54am

I'm just reading this now, but curious as to what the explanation was??

 

Originally posted by Melaniemac

Hi Dawn, did you get any answers??? I asked for our levels and now i'm even more confused   as we are both lower than Jack.

I was 0.3 and Scott was 0.4

Is this normal for carriers???

I am going to phone our Doctor to ask him to expain as i am confused

i've also sent you a pm

Melanie x

 

Dawn
Mommy to Angel Makinley (9/19/06-12/22/07) and Dalton
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Melaniemac View Drop Down
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Post Options Post Options   Quote Melaniemac Quote  Post ReplyReply Direct Link To This Post Posted: 28/January/2008 at 8:03am

It turms out Jacks and our samples were sent to different labs.

I think it is quite normal for carriers to have low levels.

this is soooo confusing .

Mel xx

 



Melanie, mummy to Jack , 28 July 2006 - 29 April 2008, forever a star
And Oliver - 13/08/09 - krabbe free!!
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Dawn M View Drop Down
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Post Options Post Options   Quote Dawn M Quote  Post ReplyReply Direct Link To This Post Posted: 28/January/2008 at 9:01am

Yeah, carriers do generally have lower enzyme levels.  It is confusing. It confuses me how different labs use different scales/ranges. It'd make much more sense it it was all the same.  

Originally posted by Melaniemac

It turms out Jacks and our samples were sent to different labs.

I think it is quite normal for carriers to have low levels.

this is soooo confusing .

Mel xx

 

Dawn
Mommy to Angel Makinley (9/19/06-12/22/07) and Dalton
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Kylesmama View Drop Down
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Post Options Post Options   Quote Kylesmama Quote  Post ReplyReply Direct Link To This Post Posted: 24/January/2010 at 8:54am
Just wondering if you ever got any answers to the enzyme level questions.

I am very confused by how this testing is done and what the level of the enzyme has to do with progression of the disease. We were told that the mutation has more to do with how the disease progresses that the enzyme level??? This is all so confusing. Do levels fluctuate??

Have any of you ever been told just how they test for the enzyme level, time it takes and what they do to find the level???
Mom to Cody, Jessa, Katie, Jordyn, and Kyle(6/19/08-)
www.caringbridge.org/visit/kyleheidrich
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