Good afternoon,
My spouse has advanced multiple sclerosis (MS). In the course of doing blood work for his MS drug, it was determined that he's quite anemic. This led to further testing, which found an abnormal light chain ratio (free kappa/lambdas 1.93) and a possible lytic lesion on a skeletal survey. His 24-hour urine results were said to be OK. His IFE is shown to be negative for monoclonal proteins, and on the SPEP, his betas are higher than the reference range. IgA levels were 2x the high end of the reference range. Another test showed "faint restricted asymmetric beta peaks".
Next step is an MRI of the bone lesion.
Do these results indicate that my spouse has multiple myeloma?
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Re: Anemia, elevated FLC ratio, and multiple sclerosis
Hi Fleur123,
What suggests to me that this may not necessarily be a monoclonal gammopathy is that his IgA is elevated and his free light chain ratio is off, yet his IFE test is negative for monoclonal proteins. If a monoclonal gammopathy were the root cause of his elevated IgA and / or an elevated free light chain ratio value, you would expect the IFE to register some monoclonal protein.
Also, an xray isn't the greatest tool for identifying lytic lesions due to myeloma and many patients have had false interpretations made by radiologists when they had a skeletal survey (including me when I was first being diagnosed). So, it's good that he is getting an MRI.
While I'm not a doctor and I don't know how many of these findings can be explained by multiple sclerosis,, I might also consider that an autoimmune disease such as rheumatoid arthritis or lupus might be at play. Both of those diseases can cause anemia and elevated IgA levels. Also, a little bit of inflammation from either disease can throw off a free light chain value. So, I would try to be patient and not necessarily assume that you are dealing with something such as multiple myeloma at this point.
Hope this helps a bit.
What suggests to me that this may not necessarily be a monoclonal gammopathy is that his IgA is elevated and his free light chain ratio is off, yet his IFE test is negative for monoclonal proteins. If a monoclonal gammopathy were the root cause of his elevated IgA and / or an elevated free light chain ratio value, you would expect the IFE to register some monoclonal protein.
Also, an xray isn't the greatest tool for identifying lytic lesions due to myeloma and many patients have had false interpretations made by radiologists when they had a skeletal survey (including me when I was first being diagnosed). So, it's good that he is getting an MRI.
While I'm not a doctor and I don't know how many of these findings can be explained by multiple sclerosis,, I might also consider that an autoimmune disease such as rheumatoid arthritis or lupus might be at play. Both of those diseases can cause anemia and elevated IgA levels. Also, a little bit of inflammation from either disease can throw off a free light chain value. So, I would try to be patient and not necessarily assume that you are dealing with something such as multiple myeloma at this point.
Hope this helps a bit.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
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