Is the SED rate always elevated in multiple myeloma patients?!


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I assume you mean Erythrocyte sedimentation rate.

The erythrocyte sedimentation rate (ESR), also called a sedimentation rate, sed rate or Biernacki Reaction, is a non-specific measure of inflammation that is commonly used as a medical screening test.

To perform the test, anticoagulated blood is placed in an upright tube and the rate at which the red blood cells fall is measured and reported in mm/h.

When an inflammatory process is present, the high proportion of fibrinogen in the blood causes red blood cells to stick to each other. The red cells form stacks called rouleaux which settle faster.

Fibrin is made from its zymogen fibrinogen, a soluble plasma glycoprotein that is synthesised by the liver. Processes in the coagulation cascade activate the zymogen prothrombin to the serine protease thrombin, which is responsible for converting fibrinogen into fibrin. Fibrin is then cross linked by factor XIII to form a clot.

Fibrin generation
Fibrinogen is a 340-KD glycoprotein synthesised in the liver hepatocytes and megakaryocytes. Dysfunction or disease of the liver can lead to a decrease in fibrinogen production or the production of abnormal fibrinogen molecules with reduced activity (dysfibrinogenaemia). Hereditary abnormalities of fibrinogen (the gene is carried on chromosome 4) are of both quantitative and qualitative in nature and include; afibrinogenaemia, hypofibrinogenaemia, dysfibrinogenaemia, and hypodysfibrinogenaemia.

So if someone with any of these diseases that negatively affect the level of fibrinogen is present, the SED may not be increased beyond the normal range.

Also if they are on any kind of drug therapy that would increase levels of antithrombin or the effects of it (Heparin), the SED would be affected towards the slower rate.

There are also several types of anticoagulant therapy that would keep the SED rate lower.

So I would assume that NO it is not always elevated.

I would ask a doctor though.

Other Answers:
With my Dad, they found out by his highly elevated calcium levels. I'm not sure about this test though.

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