Hi My Recent Blood Work Showed Low Gamma Gobulins Says

Posted on Sat, 13 Oct 2018

Question: Hi my recent blood work showed low gamma gobulins
Says Hypogammaglobulinemia
A separate panel of tests shows low lga below normal level
I have tested negative for allergies.
I have imflammed lymph nodes for over a year. They are less bad now than normal but seems to come back when I finish antibiotics. I have had several courses of antibiotics for last year
Please tell me if there is a treatment to improve my immune system? Could this be a blood cancer like CLL?
I suspect that is why hematologist/Oncologist wants me to return within 2 months. His office called and set up a follow up appt will be 5 weeks from now

Answered by Dr. Drkaushal85 (50 minutes later)

Brief Answer:
Possibility of CLL is less likely.

Detailed Answer:
Thanks for your question on Ask a doctor forum.
I can understand your concern.
Honestly speaking, possibility of CLL is less likely.
To conclude this, you need to get done Lymphnode biopsy whenever they are enlarged.
This will give exact idea.
For immunity boost up, take multivitamin tablets containing folic acid, vitamin b 12, vitamin d3, niacin, riboflavin, folic acid.
Also start anti oxidant and multimineral tablets.
Take adult vaccines like pneumococcal vaccine (every five years) and influenza vaccine (annually).
Take high protein diet.
Please let me know
1. What is your ultrasound abdomen report? Is it showing enlarged spleen?
2. Have you ever advised about lymphnode or bone marrow biopsy?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Drkaushal85 (1 hour later)

Thank you for fast response!
Spleen normal on CT scan and I never had lga deficiency before this year that I am aware of.
I want to do: lymphnode or bone marrow biopsy but don't know which kind of doctor or specialist I should see for that.

Follow up: Dr. Drkaushal85 (8 minutes later)

I also tested positive for mono ebv , high tithers . Should be uploaded in my profile. I did the test myself, no doctor recommendation. One in July, one in August.
The issue is I can't find a doctor that treats chronic mono. What kind of specialist does that?

Follow up: Dr. Drkaushal85 (2 minutes later)

I double checked just now and yes the ebv blood tests are on there in my profile.
Blessings, XXXXXXX

Answered by Dr. Drkaushal85 (3 hours later)

Brief Answer:
You should consult infectious disease specialist.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
Sorry to say but I am not finding your reports.
Can you please resend them in this question?
And in my opinion, you should consult infectious disease specialist for chronic mono infection.
For lymphnode biopsy, you need to consult surgeon and for bone marrow biopsy, you need to consult hematologist.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Drkaushal85 (42 minutes later)

Hi,
I uploaded it. Could only find one. Numbers almost same in August except E B V early antigen was higher was 45

Answered by Dr. Drkaushal85 (7 hours later)

Brief Answer:
You need to only wait and watch.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
I have gone through the report you have attached.
Well, you need to only wait and watch.
There is nothing active you can do at present.
Please let me know
1. Do you any enlarged lymphnodes?
2. Do you have fatigue?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Drkaushal85 (24 minutes later)

YES to both 1. Do you any enlarged lymphnodes?
2. Do you have fatigue?
The lymph nodes hurt at times. Under one arm and back of head, neck, jawline. Been over a year of this. Sometimes, it gets better then comes right back. :(

Follow up: Dr. Drkaushal85 (0 minute later)

Thx for helping me

Answered by Dr. Drkaushal85 (29 minutes later)

Brief Answer:
Do you know the size of lymphnode?

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
No need for thanks. As a doctor, this is my moral responsibility and duty.
Have you undergone ultrasound of lymphnode to know the size?
How you got this EBV infection?
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Drkaushal85 (5 hours later)

No, but they are small

Answered by Dr. Drkaushal85 (2 hours later)

Brief Answer:
Try to get done ultrasound examination.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
In my opinion, you first try to get done ultrasound examination of lymphnodes.
This will tell you
1. How many lymphnodes are enlarged
2. Exact size of lymphnodes.
If size of lymphnode is more than 1 cm then you should definitely get done biopsy.
I am really wondered how you got chronic ebv infection.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Drkaushal85 (55 minutes later)

That is good advice. I will see my primary and ask for ultrasound of lymph nodes.
I never thought of that! Lol
The problem is the first 6 months I was sick, doctors dismissed it as nothing, a virus/flu. I was told I had strep throat in the beginning and it sure looked like it...could not even eat was so painful...but they diagnosed it without bothering to do a throat culture.
Mono was brought up as a possibility only last November after 6 months of these symptoms.
I went and get the EBV tests and paid myself this July and August as I was still getting sick often.

Answered by Dr. Drkaushal85 (4 minutes later)

Brief Answer:
Yes, you are right about steroids and immunosuppression.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
I glad that my advice is helping you.
Yes, you are right about steroids and immunosuppression.
But ebv infection is almost always from sexual intercourse.
So he might be sexually active with ebv infected lady.
Have you test him for ebv?
Why he was taking steroid?
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Drkaushal85 (3 minutes later)

How does one acquire chronic mono?
I am 43. I am monogamous. I suspect my partner may have given it to me. He has been sick a lot too.
I suspect he has been using steroids, injecting them.
Would that somehow cause this to happen?
Perhaps his immune system became surpressed and reactivated the mono virus and caused him to shed and be contagious?
I have heard steroids cause immune system suppression.
Just fyi, I have been tested twice in last year and a half for all stds and auto immune diseases. All negative.
Ebv tithers only thing positive and high numbers at that. The hypogolumblea sorry if misspelled is something I have never had before, just diagnosed a few weeks ago.