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11 month old with abnormal kappa/lambda labs

by keeponTucking13 on Tue Jul 22, 2014 10:49 am

My 11 month old has been sick since birth, illness approximately every 2 weeks ranging from meningitis, pneumonia, croup, ear infections, eye infections, typical viruses, yeast infections, and unknown fevers.

We are getting immune testing done, and one of his labs I just received back was kappa free light chains of 0.8 mg/l, lambda free light chains of 6.6 mg/l and a kappa/lambda ratio of 0.12. These are not alarmingly abnormal to my layman's eye, but kappa is low, and the ratio is low, while lambda remains normal.

Any helpful thoughts you could share while we await the doctor's interpretation of all his lab work later this week?

Thanks in advance. :)

keeponTucking13

Re: 11 month old with abnormal kappa/lambda labs

by Joy on Tue Jul 22, 2014 1:08 pm

Hi Keepon,

I don't have any feedback on the labs but I just wanted to say I'm sorry you've had to go through so much with your baby. Hopefully they will find out the root cause of the problems soon and everything will be good.

Positive thoughts to you!

Joy
Name: Joy
Who do you know with myeloma?: myself
When were you/they diagnosed?: May 2013
Age at diagnosis: 52

Re: 11 month old with abnormal kappa/lambda labs

by Multibilly on Tue Jul 22, 2014 2:11 pm

Hi Keepon,

So sorry to hear that your baby is suffering.

First off, I'm not a doc.

It's really impossible to say what might be causing this if all you've got is the free light chain numbers. Only your doc can really tell you what's going on with any certainty.

Several different things can cause free light chain values to go out of whack. BTW, I don't think you need to worry about this being multiple myeloma as I don't recall ever hearing of an infant contracting multiple myeloma.

Systemic lupus is one thing that comes to mind since the baby suffered earlier from meningitis.

I made this association by following these links (I'm making a big assumption here that the baby had non-infectious meningitis). Again, take all this with a huge grain of salt, given I'm not a doc.

"Non-Infectious Meningitis" (Center for Disease Control & Prevention)
"Serum free light chains as biomarkers for systemic lupus erythematosus disease activity", Aggarwal et al., Arthritis Care Res (Hoboken). 2011 Jun;63(6):891-8

Best of luck to you.

Multibilly
Name: Multibilly
Who do you know with myeloma?: Me
When were you/they diagnosed?: Smoldering, Nov, 2012

Re: 11 month old with abnormal kappa/lambda labs

by keeponTucking13 on Tue Jul 22, 2014 2:27 pm

Thank you Joy.

Multibilly, I agree it seems unlikely for an infant to get multiple myeloma. This seems like the best place for folks with knowledge about these tests at least. Your thought about lupus proves interesting, especially on the immunological side that the testing originated from.

Thank you both for your input and kind words. Hoping we can "fix" up my baby soon. He turns 1 in 2 days, and I swear has gone through more in a year than I have my whole life.

keeponTucking13

Re: 11 month old with abnormal kappa/lambda labs

by Rneb on Tue Jul 22, 2014 4:12 pm

I'm Board Certified in nothing...so take this accordingly.

I suspect Your Baby has an involved Liver disease, unrelated to multiple myeloma.
Your baby also has symptoms of several possible immune system problems, but I believe they are secondary to the Liver Problem. The info you give is scant.

Get thee to a regional Children's Facility, soon. I suspect a scleralizing Cholangitis, of some form, or a ductal obstruction / malformation. Serum Amalyase, BUN, and an U/S of the Liver, etc will be very helpful.
While much lower on my diagnostic "tree"--Most of the 4 forms of Lupus can be screened fairly easily with a blood test(s).

Meningitis comes in two flavors: Viral and Bacteriological. The Sequale secondary to these, can include serious neurological, endocrine, and visual / Ontological involvement.

A full work-up is certainly indicated. Your Doc is correct to run a full panel of labs, etc. Work with him/her.

Good Luck.

Rneb

Re: 11 month old with abnormal kappa/lambda labs

by keeponTucking13 on Wed Jul 23, 2014 7:57 am

Interesting theory Rneb, and funny that you point it out cause I thought his eyes looked somewhat yellowish last night and asked my husband (whom thought they were just tired and red).

More labs:
high abs lymphs (to measure t and b cells, awaiting analysis) 2000/mm3 out of range
hib titer after 3 doses 0.84 should be greater than 1
tetanus titer ok
igg within range at 466 (283-1026) awaiting subclass anaysis
iga within range at 27 (16-82) previously low at 14 from 6 months ago
igm within range at 50 (39-141)
ige within range from 6 months ago
total protein within range 6.6 (6-8.3)
wbc, rbc, hct, hgb, plt, mcv, mch, mchc, rdw all in range
no bands
atypical/reactive lymph present (out of range)
EOS in range
manual diff shows low lymphs and low monocytes, slightly elevated neutrophils.
still awaiting SPEP, and pneumoccal titers.

Infection history related above, as well as free light chain labs.

Child also effected by asthma, reflux, milk protein intolerance (not not allergy), constipation, gross motor delays, and refusal to eat solid food.

Family history of CVID, and autoimmune endocrine issues. Thus his work up for immunedeficiency.

Meningitis was viral, 10 days post partum. No hearing exam yet, vision has problems focusing, was watch for seizures due to abnormal head/eye movements during illness and arm tremors diagnosis as benign tremors of infancy.

Expect to hear from the doctor end of the week or early next when all the results are in. I appreciate the comments left so far. I just wish for my baby to find answers and get healthy.

keeponTucking13

Re: 11 month old with abnormal kappa/lambda labs

by Multibilly on Wed Jul 23, 2014 8:07 am

Keepon,

You probably already figured this out. But, since your baby had viral meningitis, please disregard my comment about lupus. I really hope your doc gets to the bottom of this soon. I can't imagine seeing one of my kids go through this when they were so young.

Wishing your baby a speedy recovery.

Multibilly
Name: Multibilly
Who do you know with myeloma?: Me
When were you/they diagnosed?: Smoldering, Nov, 2012

Re: 11 month old with abnormal kappa/lambda labs

by keeponTucking13 on Wed Jul 23, 2014 8:56 am

Well it could be lupus (God, I sound like House!), just not the lupus caused by meningitis correlation specifically.

keeponTucking13

Re: 11 month old with abnormal kappa/lambda labs

by Paul H on Wed Jul 23, 2014 10:08 am

Hello Keepon,

I am so terribly sorry to read about your baby's ill heath and medical problems. I wish you and your family all the best for the future and hope this is resolved soon.

Paul

Paul H
Name: Paul Harvey
Who do you know with myeloma?: Myself
When were you/they diagnosed?: Feb 2014
Age at diagnosis: 43

Re: 11 month old with abnormal kappa/lambda labs

by Rneb on Wed Jul 23, 2014 11:40 am

Sorry to hear your Babe has had a rough go, since Birth.

More testing will lead to some answers, and hopefully, some treatments that will be beneficial.

My Twins were 2 +months Early--lots of NICU time, tests, tears and Prayers--- and sleepless nites. It ain't fun.

Take care of yourself.

Good luck.

Rneb

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