Hello,
I am new to this forum and the website. The reason I am posting is because I am not sure whether I could possibly have myeloma. I haven't been officially diagnosed, but from reading my lab results and from what others have told me, I believe there is a strong possibility that I do have it. I am 38 years old and otherwise in fairly good health.
My immunologist sent me to have some specific lab work done because I had been experiencing chronic hives for several months. My skin has been extremely sensitive, and she had noticed that in routine blood and urine tests that all looked well, except for elevated IgM levels. Due to that, she ordered further lab tests, and now I have been referred to a hematologist based on these results:
IFE and PE, Serum
Protein, Total, Serum 7.3 g/dL 6.0-8.5
Albumin 4.3 g/dL 2.9-4.4
Alpha-1-Globulin 0.2 g/dL 0.0-0.4
Alpha-2-Globulin 0.5 g/dL 0.4-1.0
Beta Globulin 1.0 g/dL 0.7-1.3
Gamma Globulin 1.3 g/dL 0.4-1.8
M-Spike Not Observed Not Observed
Globulin, Total 3.0 g/dL 2.2-3.9
A/G Ratio 1.5 0.7-1.7
Immunofixation Result, Serum
An apparent polyclonal gammopathy: IgM. Kappa and lambda typing appear increased.
Immunoglobulin G, Qn, Serum 1355 mg/dL 700-1600
Immunoglobulin A, Qn, Serum 140 mg/dL 90-386
Immunoglobulin M, Qn, Serum 338 H mg/dL 20-172
IFE and PE, Random Urine
Protein,Total,Urine 17.8 mg/dL Not Estab.
Albumin, U 100.0 %
Alpha-1-Globulin, U 0.0 %
Alpha-2-Globulin, U 0.0 %
Beta Globulin, U 0.0 %
Gamma Globulin, U 0.0 %
M-Spike, % Not Observed Not Observed
Immunofixation Result, Urine
Bence Jones Protein positive; kappa type.
Free K+L Lt Chains,Qn,S
Free Kappa Lt Chains,S 21.67 H mg/L 3.30-19.40 01
Free Lambda Lt Chains,S 18.19 mg/L 5.71-26.30 01
Kappa/Lambda Ratio,S 1.19 0.26-1.65
Free K+L Lt Chains,Qn,Ur
Free Kappa Lt Chains,Ur 36.80 H mg/L 1.35-24.19 02
Free Lambda Lt Chains,Ur 1.18 mg/L 0.24-6.66 02
**Results verified by repeat testing**
Kappa/Lambda Ratio,U 31.19 H 2.04-10.37
I am very worried that I have myeloma, especially because of the notation about the Bence Jones protein. If anyone could provide some insight, I would greatly appreciate it.
Thanks so much.
Joe
Forums
2 posts
• Page 1 of 1
Re: Bence Jones protein - does it mean multiple myeloma?
Hi Joe,
First off, I wouldn't jump to a conclusion of having myeloma. Moreover, if you do have a monoclonal gammopathy, it would likely be an early, benign precursor condition known as MGUS and not full blown multiple myeloma.
But more importantly, none of your serum tests suggest that you have a monoclonal gammopathy and instead all point to some sort of a polyclonal gammopathy. And even though your urine test detected Bence Jones proteins, there are explanations for your positive Bence Jones protein results that can point to something other than a monoclonal gammopathy. See the article I've referenced below.
In any case, this would be a good subject for you to follow up on with your doctor.
Reference:
Perry, MC, and Kyle, RA, "The clinical significance of Bence Jones proteinuria," Mayo Clinic Proceedings, May 1975 (abstract at Pubmed)
Abstract:
"The detection of monoclonal light chains in the urine by the Bence Jones heat test is a useful adjuvant to the diagnosis of myeloma and other related diseases. The test is particularly helpful when no serum spike is noted. Overall, it is positive in approximately half of all patients with myeloma. In order to assess the accuracy of the test, we reviewed the records of all patients with a positive heat test for Bence Jones proteinuria during a single calendar year. Myeloma accounted for 68%, but patients with amyloidosis, the adult Fanconi syndrome, and others also had positive results. One-fifth of the results were false positive in that urine protein electrophoresis showed no spike and immunoelectrophoresis, no monoclonal protein. This group consisted largely of patients with connective tissue diseases, chronic renal failure, or nonplasmacytic malignancies. We also have seen patients who had monoclonal light chains in their urine but failed to show positive results to the heat test and were thus considered false negative. Although the heat test for Bence Jones proteins is a useful clinical test, one must be aware of both false-positive and false-negative results. Electrophoresis and immunoelectrophoresis of concentrated urine are the methods of choice for detection of a monoclonal light chain in the urine."
First off, I wouldn't jump to a conclusion of having myeloma. Moreover, if you do have a monoclonal gammopathy, it would likely be an early, benign precursor condition known as MGUS and not full blown multiple myeloma.
But more importantly, none of your serum tests suggest that you have a monoclonal gammopathy and instead all point to some sort of a polyclonal gammopathy. And even though your urine test detected Bence Jones proteins, there are explanations for your positive Bence Jones protein results that can point to something other than a monoclonal gammopathy. See the article I've referenced below.
In any case, this would be a good subject for you to follow up on with your doctor.
Reference:
Perry, MC, and Kyle, RA, "The clinical significance of Bence Jones proteinuria," Mayo Clinic Proceedings, May 1975 (abstract at Pubmed)
Abstract:
"The detection of monoclonal light chains in the urine by the Bence Jones heat test is a useful adjuvant to the diagnosis of myeloma and other related diseases. The test is particularly helpful when no serum spike is noted. Overall, it is positive in approximately half of all patients with myeloma. In order to assess the accuracy of the test, we reviewed the records of all patients with a positive heat test for Bence Jones proteinuria during a single calendar year. Myeloma accounted for 68%, but patients with amyloidosis, the adult Fanconi syndrome, and others also had positive results. One-fifth of the results were false positive in that urine protein electrophoresis showed no spike and immunoelectrophoresis, no monoclonal protein. This group consisted largely of patients with connective tissue diseases, chronic renal failure, or nonplasmacytic malignancies. We also have seen patients who had monoclonal light chains in their urine but failed to show positive results to the heat test and were thus considered false negative. Although the heat test for Bence Jones proteins is a useful clinical test, one must be aware of both false-positive and false-negative results. Electrophoresis and immunoelectrophoresis of concentrated urine are the methods of choice for detection of a monoclonal light chain in the urine."
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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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