8/27/2023 0 Comments Reverse ag ratio![]() ↓ hemolytic disease, chronic active liver disease disease, chronic liver disease, iron overload ↑ causes of hypertriglyceridemia and hypercholesterolemia (inherited lipoprotein disorders, nephrotic syndrome, DM, hypothyroidism, HAC, pancreatitis, hepatic lipidosis) ![]() Α-2 lipoprotein (VLDL) May migrate as early b-1 in some species. ↓ sepsis, portosystemic shunts, liver disease, inherited (human and horse) Inhibitor of activated coagulation factors FVIII and FV ↑ nephrotic syndrome, chronic active liver disease, acute infl. ↓ in DIC, liver disease, protein-losing disorders (renal, GI) ↑ acute phase response (possible in cats) Inhibitor of thrombin and other clotting factors ↑ causes of hypercholesterolemia (inherited, nephrotic syndrome, DM, pancreatitis, hypothyroidism, cholestasis) Lipid transport – reverse cholesterol transport GlobulinsĪnti-inflammatory andimmunomodulatory functions The third fraction known as γ globulins consists of the immunoglobulins: IgM, IgA, and IgG. A few examples of globulin proteins are found in the table below. α globulins consist of α-1 and α-2 globulins, and β globulins consist of β-1 and β-2 globulins. Most of the α and β globulins are synthesized by the liver, whereas γ globulins are produced by lymphocytes and plasma cells in lymphoid tissue. These are not sure-fire indicators of multiple myeloma, but they "may" provide additional clues if any of these values are out of whack.Globulins can be divided into three fractions based on their electrophoretic mobility. Additionally, you should check if your hemoglobin (HGB) level may be low your CBC test (if you had that test done). You might also check if your creatinine or total protein levels are elevated on that same CMP test. In the meantime, some other things to check for in your current lab reports might be whether your calcium level is elevated on your comprehensive metabolic panel (CMP) test. If you let us know what city you are in, folks on this site can recommend specific hematologists and/or facilities to seek out that specialize in multiple myeloma. If any of those follow-up test results do possibly suggest multiple myeloma, your PCP would almost certainly then refer you to a hematologist for follow up. Based on those additional lab results, a PCP or many folks on this forum can then tell you if something looks potentially suspicious for multiple myeloma. Who should I even be referred to, a hematologist? I just don't know where to start.Īgain, given your situation, I might suggest just having your PCP call in the tests I mentioned to a LabCorp or Quest Diagnostics draw site and just go there to have the tests done on a Saturday (if one of them is open on a Saturday, which is pretty likely). I feel pretty trapped right now, and have no idea how I'm supposed to get the care I need when I can't take off work, you know? I didn't think that would be an issue, but now it looks like it might.Īnyhow, I am faxing my labs to my PCP tomorrow, and will see if she can refer me somewhere I guess, but I'm still not going to be able to take any time off work to even go see a specialist. Even if she stayed open til 5, I still can't use any sick time because of the probationary period, so I've had to resort to urgent care when I'm not feeling well. I work for the county here, and am in the middle of a 6 month probationary period, and work Mon through Fri 8-5. The doctor (actually, it was a PA both times.) told me both times that my labs were "totally normal" and he didn't see any cause for concern, yet I'm not getting better. That's what I've had the two blood draws. I've been feeling off lately, and with the back pain and abdominal pain, I've been to the urgent care center twice in the last two months. Multibilly Name: Multibilly Who do you know with myeloma?: Me When were you/they diagnosed?: Smoldering, Nov, 2012 To see which labs are in your area and that might be open on a Saturday, see: If the issue is that you can't get to a doctor's office on a weekday for follow-up lab testing, your doc could just call in an order for the basic follow-up multiple myeloma lab tests (IFE, SPEP, Freelite assay, quantified immunoglobulins, etc) at one of your local LabCorp or Quest Diagnostics labs (whichever your insurance covers) that is open on a Saturday. Has the doctor that ordered your last two tests suggested further testing for multiple myeloma to you? You can just call his/her office and ask. So, I take it that you don't currently have a diagnosis of multiple myeloma, but you think you might based on your elevated globulin level and thoracic pain, right?
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