Had an SPEP and only thing abnormal was alpha 1 globulin. No M spike. Serum free light chains (FLC) assay is completely normal. Doctor says I do not have myeloma. He did not do a UPEP but has now decided to do a 24 hour study. Told me that he is only doing this for my peace of mind.
What does elevated alpha 1 mean when everything else is normal?
He also said that with the serum light chain assay numbers being completely normal, the chance of finding them in my urine is low. Is this true?
Doctor said chances are slim that he will find Bence Jones proteins in my urine. I have bubbles in my urine, but not sure if that means anything. I would appreciate any information.
Doctor is a hem/onc. I asked about aymloidosis and he said very unlikely. Any ideas or opinions would be greatly appreciated. I am 52 and terrified of this.
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High alpha 1 globulin, normal serum FLC results
Last edited by Macmom on Mon Sep 29, 2014 7:24 pm, edited 2 times in total.
Re: High alpha 1 globulin, normal serum FLC results
Macmom,
Your doc is probably right that you don't have multiple myeloma based on your initial results. And if your serum free light chains are normal, chances are your urine levels will also be normal. So, I would take a deep breath and start to trust your doc on this.
What caused your doc to do an SPEP in the first place?
You don't say how high your alpha-1 is and what the normal range is on you lab result. A high alpha-1 can simply be a response to an inflammatory condition such as rheumatoid arthritis, or it could be just a testing blip. My guess is that he may want to simply re-test you down the road, depending on the level of the alpha-1 reading. But you should simply ask him what he thinks of the level and if it is a cause for any concern or any further tests.
Your doc is probably right that you don't have multiple myeloma based on your initial results. And if your serum free light chains are normal, chances are your urine levels will also be normal. So, I would take a deep breath and start to trust your doc on this.
What caused your doc to do an SPEP in the first place?
You don't say how high your alpha-1 is and what the normal range is on you lab result. A high alpha-1 can simply be a response to an inflammatory condition such as rheumatoid arthritis, or it could be just a testing blip. My guess is that he may want to simply re-test you down the road, depending on the level of the alpha-1 reading. But you should simply ask him what he thinks of the level and if it is a cause for any concern or any further tests.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: High alpha 1 globulin, normal serum FLC results
I was referred to him because of a blood calcium level of 10.7 at primary care office.
When hem/onc tested me, it was 9.7 and I had it done at the hospital and it was 9.3. My alpha 1 reading was 7.2% and normal range is 2.9-4.9%. He said he thought it was stress induced.
The other question I have is my free light chain measurements are as follows:
Kappa - 1.05 (0.33-1.94)
Lambda - 0.80 (0.57-2.63)
Kappa/lambda ratio - 1.31 (0.26-1.65).
Though normal, should I be concerned that kappa is higher than lambda and what would that mean?
All CBC and my metabolic panel results were within normal ranges.
Total Protein 7.2 g (6.2 - 8.1g)
Albumin - 55.9% (55.8-66.1%)
Alpha 1 globulins - 7.2% (2.9-4.9%)
Alpha 2 globulins - 9.5% (7.1-11.8%)
Beta globulins - 6.1% (4.7-7.2%)
Beta 2 - 4.5% (3.2-6.5 %)
Gamma globulins - 16.8. (11.8-18.8%)
No M spike detected
I am concerned about Bence Jones myeloma and amyloidosis.
When hem/onc tested me, it was 9.7 and I had it done at the hospital and it was 9.3. My alpha 1 reading was 7.2% and normal range is 2.9-4.9%. He said he thought it was stress induced.
The other question I have is my free light chain measurements are as follows:
Kappa - 1.05 (0.33-1.94)
Lambda - 0.80 (0.57-2.63)
Kappa/lambda ratio - 1.31 (0.26-1.65).
Though normal, should I be concerned that kappa is higher than lambda and what would that mean?
All CBC and my metabolic panel results were within normal ranges.
Total Protein 7.2 g (6.2 - 8.1g)
Albumin - 55.9% (55.8-66.1%)
Alpha 1 globulins - 7.2% (2.9-4.9%)
Alpha 2 globulins - 9.5% (7.1-11.8%)
Beta globulins - 6.1% (4.7-7.2%)
Beta 2 - 4.5% (3.2-6.5 %)
Gamma globulins - 16.8. (11.8-18.8%)
No M spike detected
I am concerned about Bence Jones myeloma and amyloidosis.
Re: High alpha 1 globulin, normal serum FLC results
Did your doctor mention amyloidosis as a possibility? If your doc thought you potentially had amyloidosis, he would recommend a specific biopsy test to look for the amyloid protein. While I'm not a doc, nothing on these test results suggest to me that you have it.
Also, with normal free light chain values (which you have ... don't expect them to be equal in value), I'm not sure why you think you may have Bence Jones multiple myeloma (which is a very specific kind of multiple myeloma) . Are you speculating on these potential diagnoses through your own research on the Internet?
Really, I would try to remain calm and just wait for your urine test and then take things from there regarding the slight hypercalcemia and elevated alpha-1 globulin. I bet the urine test will also show normal free light chain values since your serum free light chains are normal ... and further confirm that you in fact don't have multiple myeloma.
My guess is that your doc will simply suggest you have your calcium and alpha-1 retested in the near future ... but I'm not a doc, so please keep that in mind.
Also, with normal free light chain values (which you have ... don't expect them to be equal in value), I'm not sure why you think you may have Bence Jones multiple myeloma (which is a very specific kind of multiple myeloma) . Are you speculating on these potential diagnoses through your own research on the Internet?
Really, I would try to remain calm and just wait for your urine test and then take things from there regarding the slight hypercalcemia and elevated alpha-1 globulin. I bet the urine test will also show normal free light chain values since your serum free light chains are normal ... and further confirm that you in fact don't have multiple myeloma.
My guess is that your doc will simply suggest you have your calcium and alpha-1 retested in the near future ... but I'm not a doc, so please keep that in mind.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: High alpha 1 globulin, normal serum FLC results
To summarize, you were initially tested due to a laboratory value that later proved to be erroneous. Your monoclonal gammopathy labs are all within normal limits. You may have some elevated inflammatory proteins, but I can see zero signs suggesting amyloidosis, myeloma, or any related condition. Obviously, I will defer to your doctor, who is looking at all the data, but I see no reason for any additional tests or retesting.
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Dr. James Hoffman - Name: James E. Hoffman, M.D.
Beacon Medical Advisor
Re: High alpha 1 globulin, normal serum FLC results
My additional concerns are my kidney function has gone down in the last year (even though it's still in the normal range), I bruise easily, and I have bubbles in my urine.
Re: High alpha 1 globulin, normal serum FLC results
Macmom,
Did you have a routine urinalysis done? If so, did it show protein in your urine?
I also noticed bubbles in my urine and saw my primary physician regarding this concern last month. The routine urinalysis showed 2+ protein with microscopic hematuria. Random urine protein - 253, (normal 0-15). Protein/creatinine ratio - 1,248, (normal 0-200). Urine microalbumin/creatinine ratio - 639 (normal 0-30). July serum kappa light chain analysis was 10,040 mg/L, which is crazy high.
My serum and urine creatinine are normal. I have high risk smoldering multiple myeloma.
A similar symptom I experience is pinch purpura or bruising to my face since 2011.
This week I have an appointment with a kidney specialist.
Drinking plenty of water, avoiding non-steroid anti-inflammatory medication, and avoiding red meat were recommended by my primary physician to keep the protein down in my urine.
I wish you much luck in getting to the bottom of bubbles in your urine.
Regards, Margo
Did you have a routine urinalysis done? If so, did it show protein in your urine?
I also noticed bubbles in my urine and saw my primary physician regarding this concern last month. The routine urinalysis showed 2+ protein with microscopic hematuria. Random urine protein - 253, (normal 0-15). Protein/creatinine ratio - 1,248, (normal 0-200). Urine microalbumin/creatinine ratio - 639 (normal 0-30). July serum kappa light chain analysis was 10,040 mg/L, which is crazy high.
My serum and urine creatinine are normal. I have high risk smoldering multiple myeloma.
A similar symptom I experience is pinch purpura or bruising to my face since 2011.
This week I have an appointment with a kidney specialist.
Drinking plenty of water, avoiding non-steroid anti-inflammatory medication, and avoiding red meat were recommended by my primary physician to keep the protein down in my urine.
I wish you much luck in getting to the bottom of bubbles in your urine.
Regards, Margo
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3334 - Name: Margo
- Who do you know with myeloma?: myself, father
- When were you/they diagnosed?: Myself - Feb 2013, Father - Sept 2003
Re: High alpha 1 globulin, normal serum FLC results
Margo,
Did you have a serum work up? What were the results? No protein on urine analysis, but they didn't do all of the other urine tests.
What kind of test did they do to come up with those results?
Did you have a serum work up? What were the results? No protein on urine analysis, but they didn't do all of the other urine tests.
What kind of test did they do to come up with those results?
Re: High alpha 1 globulin, normal serum FLC results
Do you have swelling in your hands, feet, or face? It is my understanding that bubbles in the urine could also be caused from urinary tract infections, slight dehydration, pregnancy, rapid urination, and more reasons other than just proteinuria.
My serum glucose, calcium, protein, creatinine, alpha 1 globulin are normal. My serum albumin is slightly low at 2.9 g/dl, my cholesterol is 223.
The simple dipstick urine test was done for the protein and hematuria result. This result was back in less than 3 minutes (dipstick urine tests can be done at home).
A random urine specimen was collected for protein and creatinine. A 24-hour urine test was sent for creatinine. Both of those tests were ordered by a nurse practitioner. My hematologist orders a CBC, comprehensive chemistry, SPEP, serum immunofixation (IFE), and beta 2 microglobulin every 90 days to monitor my smoldering myeloma.
I think the nephrologist was consulted to monitor and possibly treat the proteinuria and future kidney problems, which could result as complications of having high free kappa light chains.
In January 2013, my random protein was 2.0 and free kappa light chain 4815 mg/L. The bubbles in my urine started about 4 or 5 months ago.
I used to waste too much time worrying about abnormal lab results, possible diagnoses, and symptoms. Thankfully, I have less anxiety now. I recite the Serenity Prayer a lot.
Best wishes and good luck, Macmom!
My serum glucose, calcium, protein, creatinine, alpha 1 globulin are normal. My serum albumin is slightly low at 2.9 g/dl, my cholesterol is 223.
The simple dipstick urine test was done for the protein and hematuria result. This result was back in less than 3 minutes (dipstick urine tests can be done at home).
A random urine specimen was collected for protein and creatinine. A 24-hour urine test was sent for creatinine. Both of those tests were ordered by a nurse practitioner. My hematologist orders a CBC, comprehensive chemistry, SPEP, serum immunofixation (IFE), and beta 2 microglobulin every 90 days to monitor my smoldering myeloma.
I think the nephrologist was consulted to monitor and possibly treat the proteinuria and future kidney problems, which could result as complications of having high free kappa light chains.
In January 2013, my random protein was 2.0 and free kappa light chain 4815 mg/L. The bubbles in my urine started about 4 or 5 months ago.
I used to waste too much time worrying about abnormal lab results, possible diagnoses, and symptoms. Thankfully, I have less anxiety now. I recite the Serenity Prayer a lot.
Best wishes and good luck, Macmom!
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3334 - Name: Margo
- Who do you know with myeloma?: myself, father
- When were you/they diagnosed?: Myself - Feb 2013, Father - Sept 2003
Re: High alpha 1 globulin, normal serum FLC results
Did your kappa free light chains show up in your serum (SPEP) or urine (UPEP) tests?
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