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What does high rheumatoid factor and low IgG indicate? - Online Doctor Chats

Date : 26-Mar-2014
User rating for this question
Very Good Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
User:my Chinese girlfriend in Beijing had a blood test. Her RF was high (rheumatoid factor). Her IgG was low. (positive gamma globulin test). Otherwise everything else was normal. She went in for tests as she will occasionally feel weak and feel very cold.Not often but occasionally. She is 38 yrs. old.
Let me read your query for few minutes to be able to have a good discussion here.
Doctor:Hi, I have gone through your query...
Doctor:The symptoms are not very usual
Doctor:The important aspects are positive Rheumatoid factor, low IgG levels
Doctor:Blood pressure seems to be fine
User:Most time she is very active. Her one joint knee is occasionally sore. The low IgG scared her as they had leukemia on the differential diagnosis
Doctor:I think, by saying feeling suddenly tired and hands becoming cold suddenly, you mean she gets dizzy and experiences that faint feeling
User:She doesn't faint but becomes very weak. It passes in 30 minutes. I have seen it first hand, she is fine then her hands get very cold. It is unusual.
Doctor:Considering her blood pressure being on the lower margin of normal I suspect she has "Syncope" or near syncope, that is fainting or near fainting
Doctor:Feeling week for 30 minutes is unusual
Doctor:Generally if one has an episode of syncope, they faint or they have to sit down to avoid fainting
Doctor:and within minutes they will not feel weak anymore
Doctor:To correctly identify the problem, her blood pressure needs to be monitored closely
User:Now she has been under abundant stress for the last month. Her father died and all of a sudden she had to deal with everything as the mother is quite helpless. After the 30 minutes she feels fine again and walks around like nothing happened. What is the IgG about
Doctor:that is.. repeated measurements should be taken in different positions
Doctor:IgG is type of immunoglobulin that is produced by a particular type of white blood cells
Doctor:One reading is not conclusive of anything
Doctor:You will have to repeat that again to see if there is any change
Doctor:Usually some acute viral infections or malnutrition can cause a decrease in the IgG levels
User:leukocytes right. I know a bit but as you know a bit of information is sometimes worse. She is going in again tomorrow. she has had a cold for about 10 days. As I said she has been under much stress from her mother and relatives to deal with everything. Can stress affect IgG?
Doctor:In my practice I would advise the following course of action in a similar condition
Doctor:Yes, stress can affect the IgG levels
User:What she do next?
Doctor:I would advise 1. Blood pressure measurements by a doctor in different positions, that is lying down, sitting, and standing
Doctor:2. ECG to rule out any heart rhythm issues
Doctor:3. Thyroid profile
User:She has had an ECG and it was fine
User:Thyroid profile?
Doctor:4. Blood tests, including, complete blood counts, Serum electrolytes, Liver function tests, and Kidney function tests
Doctor:Thyroid profile means, estimation of Thyroid hormones, that is T3, T4 and TSH
Doctor:And also the IgG and other immunoglobulin levels to see if there is any change
Doctor:It is good that her ECG is fine
Doctor:Please get these tests done and consult an Internal Medicine specialist
Doctor:Anemia can also cause such symptoms
User:A thyroid profile needs to be specified correct. It is not shown on a regular blood test is that correct?
Doctor:The probabilities are quite a few
Doctor:Yes, Thyroid profile needs to be specified
User:Thank you I will be seeing her again in a couple of weeks. This will help.
Doctor:is there anything else I can help you with?
User:No I have what I need to direct her on to the next step in finding out things.
Doctor:Okay.. it was nice chatting with you
Doctor:have a good day ahead
Doctor:Thank you
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