Decrease in Immunoglobolins (IgM, IgG, IgA)

[Alysia]

Hi,

My wg dr. Told me to check my Immunoglobolins.

https://www.creative-diagnostics.com/blog/index.php/clinical-significance-of-five-immunoglobulin-tests/

He said that over the years, with long use of rtx (not sure if also with long use of other immune suppresed meds ? ) there is a decrease in them.

I got my blood tests' results back and compared them to previous years. Indeed a decrease:

I first started rtx on 2013. My IgM on 2013 was 84. At 2016 it was already 48 and now it is 45. The lowest normal border is 40. So I am getting closer to it.

My IgG was 1044 on 2013, 936 on 2016 and 856 now. The lowest normal border is 737. So also getting closer.

My IgA was 232 on 2013, 193 on 2016 and now 173 but the lowest normal border is 70. So this one is less bad, I guess.

How much are yours ?

I wonder if this tendency of decrease continue untill your immunglobolin are under the normal ?

And then - what next ??

[nagesh]

Hi
This is nagesh my son nischal is facing the same problem, He is on Rituxan for maintenance since 4 years recently his protein in urine is up and we are suspecting of a kidney flare, he is on protocol of once in 6 months 500mg Rituxan for maintenance. now, it is only 5 months from last Rituxan and suspecting a flare, This is first time his IgG level is low with reading of 533 as against normal range of 700 to 1600. Here his treating Rheumatologist is not in favour of giving Rituxan when IgG is low and asking us to wait for one more month and see if IgG is up then he will consider for Rituxan, Mean time he has increased the Prednisolene to 40mg and started Azoran, Worried what if IgG levels doesn't come up

[Alysia]

Hi
This is nagesh my son nischal is facing the same problem, He is on Rituxan for maintenance since 4 years recently his protein in urine is up and we are suspecting of a kidney flare, he is on protocol of once in 6 months 500mg Rituxan for maintenance. now, it is only 5 months from last Rituxan and suspecting a flare, This is first time his IgG level is low with reading of 533 as against normal range of 700 to 1600. Here his treating Rheumatologist is not in favour of giving Rituxan when IgG is low and asking us to wait for one more month and see if IgG is up then he will consider for Rituxan, Mean time he has increased the Prednisolene to 40mg and started Azoran, Worried what if IgG levels doesn't come up

Hi Nagesh, I am sorry that your son has to deal with this now. How much is his creatinine ?
I am on rtx 2000mg every 6 months, much higher doze then your son. But without other immune suppresed meds.
Do they consider Igiv treatment for him to increase his IgG ?
Sending prayers. Please update us.

[NatriceRomeo]

Hey Alyssa and WG fam,
Prior to me starting RTX, my Dr checked my IgG level. It was already low from years of other biologicals. My Dr does not seem concerned since starting the RTX my infections have actually gone down! Crazy!
Natty


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[nagesh]

Hi Nagesh, I am sorry that your son has to deal with this now. How much is his creatinine ?
I am on rtx 2000mg every 6 months, much higher doze then your son. But without other immune suppresed meds.
Do they consider Igiv treatment for him to increase his IgG ?
Sending prayers. Please update us.

Hi Alysia

Thanks for your reply, His creatinine is in normal, Usually his flare indicator will be up in protein and inflammation in eyes which we will be monitoring once in two months and review with Dr, He is on maintenance with Rituxan 500mg once in six months no other suppressants, I have to check with Dr about Igiv, Am pursuing Dr to give him Rituxan as early as possible, This time he may suggest for 1000mg but IgG is ? , I have Dr's next appointment after two weeks have to wait till then and see what plans he suggests.
I have learnt lot about wg from this forum many questions i take from here to Dr that way people from this forum are helping a lot.

Thank you

[Alysia]

@nagesh (https://www.wegeners-granulomatosis.com/forum/member.php?u=580) any update about your son ?

I went to see my wg dr. He said to look after the IgG. He is not too worried about mine but we decided to try to get rtx after 7 months and not 6 months. I hope I will be able to hold on without too much smolderimg or a flare.

[nagesh]

Hi Alysia

Good to know about your RTX plans,
Next week i have appointment with Dr. have to repeat IgG test and see what plans he suggests, will update.

[nagesh]

Hi Alisya

With the up in steroids there is some decrees in protein levels, IgG has not improved, as per Dr once the B cells starts populating IgG levels will comeup means as long as RTX is active(working) IgG will be low. Still he asked us wait for 6 weeks and check IgG to initiate RTX plans.

[Alysia]

Hi Alisya

With the up in steroids there is some decrees in protein levels, IgG has not improved, as per Dr once the B cells starts populating IgG levels will comeup means as long as RTX is active(working) IgG will be low. Still he asked us wait for 6 weeks and check IgG to initiate RTX plans.

Thanks for the update. I am glad the steroids help although not with the Igg. Sending prayers for your son and for you.