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Phil
Phil, Doctor (MD)
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Experience:  Specialize in internal medicine and pediatrics, also have a PhD in pharmacology
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MMR titer values high for Mumps, Rubeola

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Situation: 35 year old male, recent MMR titer due to heading back to school, was flagged as high for Rubeola at 1.48, Mumps titer at 4.11. According to lab sheet >1.09 is positive for immunity for both. Rubella was not flagged as high and was 26. Family MD and ER Doc friend both don't have any answers as to what this could indicate. Also it should be noted that I only had 1 MMR shot at around 1 year of age with no booster shots or other vaccinations of any type after approx 1 year of age.

Thanks for any information.
Submitted: 8 years ago.
Category: Health
Expert:  Phil replied 8 years ago.
Hello!

While I'm not sure what the reference ranges mean for the test that you have, I can interpret the answers for you.

The rubeola and mumps titers simply mean that you have good immunity against both of those diseases. "positive" is really all that matters. The titer itself does not, and can vary widely from person to person. Simply put, when you received the vaccination as a child, you launched a great immune response to it, and in fact, it doesn't sound like you NEED a booster for either of those two diseases. You're well-protected. Congratulations!

For the rubella, if "26" is not "positive" according to the reference range that you have, it means you may NOT be protected if you come in to contact with someone who has that disease. It's pretty rare, but it is dangerous, although mostly only to pregnant women. However, I have certainly seen a number of patients who are NOT rubella immune, although the only time we check is if a woman is pregnant, or in your situation, as you go back to school.

My recommendation would be to get another rubella booster shot. Not sure if you can get the shot without the Measles and Mumps in it, but if not, getting those vaccines again won't hurt you, although we've already mentioned that you don't NEED them.

More info can be found at the following website:
http://www.immunize.org/catg.d/p2021c.htm

Good luck.
Customer: replied 8 years ago.
Reply to Phil's Post: Just to clarify the rubell antibodies, IgG was 26, greater than 9 is immune, but this value wasn't flagged as high, but the other 2 were. Mumps Abs, IgG, EIA was 1.48 and that was flagged as high. Mumps Abs, IgG was 4.11 and again flagged as high.

I had considered that maybe my body did demonstrate significant immune response to just 1 shot at a very early age, but was concerned over the Mumps and Rubeola flagged as high.

My online searching did yield some info regarding certain autoimmune disorders associated with high measles titer, and I then started thinking if this needs to be looked into further. Although I have no outward symptoms of any problem whatsoever, I am wondering if I should have additional blood tests, whether just a general workup or some specific lab tests.

Again thanks for your response and insight into this matter.
Expert:  Phil replied 8 years ago.
Thanks for the clarification on some of the values.

So here's some more info for you, and I hope this makes sense. In the context of an autoimmune disorder, you could develop higher titers of antibodies to all sorts of different things, ranging from proteins in your cell, to proteins on your cell surface, to even DNA itself, which you definitely shouldn't have autoantibodies to. Now, it's certainly reasonable that you might also develop higher titers for antibodies against, say, the measles antigen too. HOWEVER, having this higher antibody titer ALONE does not cause disease, at least not for the measles antibody titer. It's merely an association, rather than a cause/effect relationship, as far as I know. Look at it like this: say you have an autoimmune disease like lupus, and I draw your blood and look at your antibody titers to 10 different molecules. They may be ALL really elevated, but that doesn't mean that having more antibodies (or having STRONGER antibodies) is associated with ANY of the disease process itself. They're simply markers that you have something going on with your immune system. But just because you have them, does NOT mean you are sick. Now, certain autoantibodies (like antibodies against your own DNA, or against certain proteins), we know those antibodies are destructive. However, higher than normal antibody titers for measles? That ALONE may not mean anything.

But, if you were to suddenly develop aching joints, or an unusual rash, or kidney failure, we'd start fishing for an autoimmune disease, and THEN the information might become more important (although it may or may not change how we manage the disease).

As it is, we really don't understand autoimmune diseases that well. There's so much research going on that looks at how we develop antibody responses to vaccines, and we're still working out how we know our own proteins from those of invaders, or from those of cancer cells, for instance. Autoimmune diseases are a pretty big black box, and when you get one, it can be pretty depressing because many of our therapies aren't very specific: they depend on knocking down your immune system with steroids to try and chill out your body from making antibodies against your own body, which is clearly not good. However, we don't know why people get them, nor how to treat them very well (although we're getting better).

Were I you, I'd chalk it up to having a pretty good immune response, and call it a day. Remember, the "norms" for any lab value are established like anything else: they look at where 95% of people fall, call that normal, and call everything else abnormal... even though it may be perfectly okay for you to have an even higher value. I wouldn't get any other lab tests, or work it up further.

And if you have the misfortune of developing an autoimmune disease, or symptoms of one, bring up our conversation and mumps and rubeola titers. It won't likely lead to any amazing diagnoses, but it can add a little more information to the picture.

And, 1 more thing... doesn't sound like you need a rubella shot either, which is great.

I hope all this makes sense. Please let me know if it doesn't.

-Phil
Phil, Doctor (MD)
Category: Health
Satisfied Customers: 76
Experience: Specialize in internal medicine and pediatrics, also have a PhD in pharmacology
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