[vurfam]

Do these lab results diagnose multiple myeloma?

by vurfam on Tue Mar 22, 2016 6:57 pm

Hi,

Below are my husband's blood work results. He has his total protein elevated in his physical in February 2016, leading to being referred to a hematologist and all these tests. He is doing his 24-hour urine today.

I am really worried. I have been searching online to figure out what the results mean. We are newly married and have a baby who just turned 1. We are scheduled to discuss these results with the doctor 3 weeks later from today. I am getting depressed by this waiting game, be it for the labs, results, or appointments.

Test Results

Immunoglobulins A/G/M, Qn, Ser

Immunoglobulin M, Qn, Serum 102 (20-172) mg/dL
Immunoglobulin A, Qn, Serum H 490 (90-386) mg/dL
Immunoglobulin G, Qn, Serum H 1908 (700-1600) mg/dL

Free K+L Lt Chains,Qn,S

Free Kappa Lt Chains,S H 27.94 (3.30-19.40) mg/L
Free Lambda Lt Chains,S 19.76 (5.71-26.30) mg/L
Kappa/Lambda Ratio,S 1.41 (0.26-1.65)

Sedimentation Rate-Westergren 7 (0-15) m­m/hr
C-Reactive Protein, Quant 2.1 (0-4.9) mg/L

Comp. Metabolic Panel (14)

Glucose, Serum 85 (65-99) mg/dL
Bun 10 (6-20) mg/dL
Creatinine, Serum 0.76 (0.76-1.27) mg/dL
Egfr If Nonafricn Am 117 (>59) mL/min/1.73
Egfr If Africn Am 136 (>59) mL/min/1.73
Bun/Creatinine Ratio 13 (8-19)
Sodium, Serum 140 (134-144) mmol/L
Potassium, Serum 4.6 (3.5-5.2) mmol/L
Chloride, Serum 100 (97-108) mmol/L
Carbon Dioxide, Total 26 (18-29) mmol/L
Calcium, Serum 9.5 (8.7-10.2) mg/dL
Protein, Total, Serum 8.0 (6.0-8.5) g/dL
Albumin, Serum 4.4 (3.5-5.5) g/dL
Globulin, Total 3.6 (1.5-4.5) g/dL
A/G Ratio 1.2 (1.1-2.5)
Bilirubin, Total 1.1 (0.0-1.2) mg/dL
Alkaline Phosphatase, S 77 (39-117) IU/L
Ast (Sgot) 27 (0-40) IU/L
Alt (Sgpt) 44 (0-44) IU/L

[Multibilly]

Re: Do these lab results diagnose multiple myeloma?

by Multibilly on Tue Mar 22, 2016 7:03 pm

Hi Vurfam,

Welcome to the forum, but sorry you are going through all this angst.

One can't tell if one has a monoclonal gammopathy such as MGUS, smoldering multiple myeloma or multiple myeloma from just these tests alone. However, if a hematologist ran the tests you already posted, he most likely also ran what is called a serum immunofixation test and a serum protein electrophoresis test. Do you have the results of those tests?

[vurfam]

Re: Do these lab results diagnose multiple myeloma?

by vurfam on Tue Mar 22, 2016 7:18 pm

Hi Multibilly,

Thanks for posting a reply. I have been reading your posts in these forums and I must say they are of immense help for someone like me. Please keep doing what you are doing.

The doctor said he is going to run the immunofixation test as well. Probably the results are not out. I am constantly checking my husband's Labcorp account.

When we visited the doctor, he told if both IgG and IgA increase it could be a case of polyclonal gammopathy or something from a recent infection, and I was hoping it would be something of that nature because my husband had a stye due to staph at the time of his physical.

But after seeing that his Free Kappa Lt Chains, S are high, I am totally confused.

Do you know if Free Kappa Lt Chains,S elevate in cases other than myeloma?

Thanks.

[Multibilly]

Re: Do these lab results diagnose multiple myeloma?

by Multibilly on Tue Mar 22, 2016 7:39 pm

Vurfam,

I'm glad you brought up the subject of polyclonal immuno­globulins.

I'm not a doc and only your doc should make this call. But when I first looked at your husband's lab results, I was actually thinking about some sort of polyclonal issue given your the high kappa, normal lambda, and normal kappa/lambda ratio - plus the fact that BOTH the IgG and IgA are elevated.

If the immunofixation and electrophoresis tests show no monoclonal protein, then one would likely start trying to figure out what is causing the polyclonal immunoglobulin increases.

See this article to see likely causes for polyclonal immunoglobulin increases:

https://labtestsonline.org/understanding/analytes/immunoglobulins/tab/test/

[vurfam]

Re: Do these lab results diagnose multiple myeloma?

by vurfam on Tue Mar 22, 2016 7:48 pm

Thanks Multibilly. This article is really helpful in understanding polyclonal vs monoclonal.

I will post the other results once they are out.

[vurfam]

Re: Do these lab results diagnose multiple myeloma?

by vurfam on Mon Apr 04, 2016 9:54 pm

We got the results for UPEP, SPEP, and IFE. Not sure what the reports suggest, would be visit­ing the doctor this Thursday. Any insight would be helpful. Thanks!

Ife+Protein Electro, 24-Hr Ur
-------------------------------------
Immunofixation Result, Urine
An apparent normal immunofixation pattern.

M-Spike, % Not Observed
Gamma Globulin, U 0
Beta Globulin, U 0
Alpha-2-Globulin, U 0
Alpha-1-Globulin, U 0
Albumin, U 100
Prot,24hr Calculated 330.6 HIGH (30.0-150.0 mg/24 hr)
Protein,Total,Urine 11.6 (0.0-15.0 mg/Dl)

Ife And Pe, Serum
------------------------
Immunofixation Result, Serum
An apparent polyclonal gammopathy: IgG and IgA.
Kappa and lambda typing appear increased.

A/G Ratio 1 0.7-2.0
Globulin, Total 3.9 (2.0-4.5 g/dL)
M-Spike Not Observed Not Observed
Gamma Globulin 1.8 high (0.5-1.6 g/dL)
Beta Globulin 1.4 high (0.6-1.3 g/dL)
Alpha-2-Globulin 0.5 (0.4-1.2 g/dL)
Alpha-1-Globulin 0.2 (0.1-0.4 g/dL)
Albumin 3.8 (3.2-5.6 g/dL)
Protein, Total, Serum 7.7 (6.0-8.5 g/dL)

Immunoglobulin M, Qn, Serum 102 (20-172 mg/dL)
Immunoglobulin A, Qn, Serum 469 HIGH (90-386 mg/dL)
Immunoglobulin G, Qn, Serum 1848 HIGH (700-1600 mg/dL)