Anyone know about Globulin levels

[Shamrockgirl]

Anyone had experience of “low globulin” count when having a blood test? Had my monthly Methotrexate blood test last Tuesday, the GP rang me Wednesday afternoon to say my globulin count was a bit low & with my “Rheumatoid factor”. Of course he didn’t explain what it was & when I asked what needed to be done, he said would check it again at February’s bloods. I looked up globulin & see it’s a protein in the blood, can cause fatigue, you don’t say😭 My fatigue levels have been very bad last few weeks, but put it down to RA, Fibromyalgia & ME, time of year, Covid & family worries.

[Neonkittie17]

My low (Ig) immunoglobulin levels (globulins or gamma globulins or white blood cells are other terms for your Ig’s) are due to immunosuppression on a powerful biologic. You can feel low/tired if your Ig’s are out of sync and often be more prone to infections. I notice that with my own. I am sure your rheumy will be keeping an eye on your results and as they can fluctuate each time. I hope yours improve next test. I see it was your GP who told you. Do you have the option to speak with your rheumy nurse and ask?

[Lolabridge]

Good info and advice from Neonkittie. I agree it’s worth messaging your Rheumy nurse.

[Marionfromhappydays]

There are alot of "globulins" but i suspect the type they are referring to are your immunoglobulins.

As neokittie says its a varying classes of white blood cells, sometimes our medication can make them low.

[oldtimer]

That doesn't sound a very helpful discussion. It's not surprising you are looking for more information. Perhaps worth discussing it on your rheumatology help line?

[timmay111]

I agree with Neonkittie17. I was treated with rituximab about six months ago, and my IgA, IgG and IgM levels have dropped below the lower limit of normal recently. Turns out that this drop in Ig’s is not terribly unusual; this occurs in about 10% of patients using rituximab at about the six month mark. And this also occurs with methotrexate.

A major consequence of low Ig’s is susceptibility to infections. And if repeated infections occur, then anti pathogens might be prescribed. After my diagnosis I went on a 3 month daily prophylactic regimen of antibiotic, antiviral, and anti fungal meds, for a slightly different danger (very low neutrophils), and then stopped when this recovered—and there were no adverse events with these, and no infections

Therapy for extreme Ig deficiencies may be available, but Ig’s only last for one to three weeks, so the therapy doesn’t seem particularly helpful.

I hope this is helpful; please stay safe!

[Neonkittie17 in reply to timmay111]

Hi Timmay, was that your first/only Rtx or are you planning to continue? If you have dropped <3 IgG you qualify for ivig apparently. Even at mild hypergammaglobulinemia you can still get a lot of infections which tend to happen when it drops to around 6. I was told recently by an immunologist that due to a lot of hypergamma cases with Rtx and Mtx they had to lower the threshold to <3 re qualifying for ivig. Was your anti viral prescribed to help restore the Ig’s? I’ve not had that suggested from the immunologist.

[timmay111 in reply to Neonkittie17]

The anti's were because of neutrophils down in the 0.3's for awhile (I have a non Hodgkin Lymphoma). It was purely protective during that period. A standard rtx treatment for this disease is infusions once/week, four times; and then another series if needed, which I needed. My last infusion was July 2, so I'm close to the 6 month thing. But yeah, IVIG might be needed if it doesn't rebound. Worried. Optimistic. Nurses have been responsive. I don't have your fatigue, thank goodness.Thanks Neonkittie, be safe.

[Neonkittie17 in reply to timmay111]

Ah thank you I see that your Rtx is for lymphoma so more frequent over the month. I do know of that. Igs/cells depleted faster/intensely over the intense, shorter period of treatment. I do hope this is successful for you. 🙏🏻 I thought you were on Rtx for RA. My RTx was/is since early 2014. I just wondered if you’d had a new way of treating hypergamma with Rheumatoid. My neutrophils are normal, it’s lack of B cells of course causing low Ig’s/ hypergamma causing respiratory episodes. I hope all goes well for you. It’s Shamrock who said about her fatigue. I’m rather more tired than I should be at times with low igG and igM, but I still have an amazing energy to do a lot of things. Just gotta pace it now and then. Take care.