The activation of humoral complement has long been associated with immune complex injury and the Arthus response ( 2). These data indicate a dominant role for the C5aR and its ligand in the reverse passive Arthus reaction in the lung and a synergistic role together with other inflammatory mediators in immune complex–mediated peritonitis and skin injury. In contrast to our studies in immune complex–induced lung inflammation, C5aR deficiency does not completely prevent injury in the peritoneal cavity and skin. In the reverse passive Arthus reaction in the skin the C5aR was also required for the full expression of neutrophil influx and edema formation C5aR-deficient mice showed reduced neutrophil migration and microvascular permeability changes. C5aR- deficient mice exhibit decreased migration of neutrophils and decreased levels of TNF-α and interleukin 6 in the peritoneal reverse passive Arthus reaction compared to their wild-type littermates. In this study, we compare the effect of C5aR deficiency in immune complex–induced inflammation in the peritoneal cavity and skin with the results derived from our immune complex alveolitis model. These are not sure-fire indicators of multiple myeloma, but they "may" provide additional clues if any of these values are out of whack.We recently demonstrated that gene-targeted disruption of the C5a anaphylatoxin receptor prevented lung injury in immune complex–mediated inflammation. 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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