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Sarcoidosis

Globulin 4.1

05/03/2007

Question:

I take cellcept (and prednisone as well as many other meds)for systemic sarcoidosis. My globulin is always high...this past time was 4.1. My A/G ratio was 0.9. My WBC`s were 13.8 but have always been up since on the prednisone.

My question is this: does the inflammation from the sarcoid cause an increased globulin? If so, is this a reliable indicator of disease activity. I am in a sarcoid flare right now with my eyes and joint/muscle pain. I`m especially glad now that I had the AICD implanted for the cardiac sarcoid.

As always, thank you for your time and helping those of us with this disease.

Answer:

This is an excellent question. It is intuitive that more active disease would correlate with higher levels of immunoglobins, reflective of a vigorous immune response. There are a few studies that have been published on this topic. A recent study conducted in an Asian population showed higher levels of immunoglobins in patients who had inactive disease. An older study, involving a larger European patient population, showed no correlation between immunoglobin levels and disease activity.

The authors of the latter study suggested that immunoglobin levels were not useful for measuring disease activity. In practice, I am not aware of any doctors who use the immunoglobin level to determine disease activity.

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Response by:

Elliott D Crouser, MD Elliott D Crouser, MD
Associate Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University