[Julie23]

Faint ill-defined band of IgM, type kappa, detected

by Julie23 on Mon Mar 14, 2016 11:18 am

Hi everyone,

I would really appreciate some help. I am a 34 year old Canadian female who received some blood and urine tests due to extreme exhaustion. My lab results were as follows:

• IgM 6.66 (normal is 0.4 - 2.30)
• Total protein in electrophoresis 83 (normal is 60 - 82)
• It said my serum protein electrophoresis pattern appears normal
• Immunoelectrophoresis comments say: "A faint ill defined band of IgM, type kappa, is detected. Unable to provide an estimate of the amount of the monoclonal band. Please submit another specimen in 6 -12 months to confirm observations."

Can someone please let me know what this means. I have an appointment with a hem/onc in 2 months and would love and appreciate any feedback/advice. I also have a slightly enlarged liver, one kidney cyst, one kidney stone, a cyst on my uterus. I had an benign exostosis bone tumor removed at 16 years old and a lipoma removed 3 years ago. I have back pain but I'm pretty sure it's from my scoliosis. I also have frequent infections (e.g., sore throat, strep throat, bronchitis, etc)

Thank you so much,

Julie

[Multibilly]

Re: Faint ill-defined band of IgM, type kappa, detected

by Multibilly on Mon Mar 14, 2016 5:29 pm

Hi Julie,

Welcome to the forum.

An elevated IgM level can be associated with a variety of different disorders. See this article for potential causes:

"1. Increased serum immunoglobulin concentrations occur due to polyclonal or oligoclonal immunoglobulin proliferation in hepatic disease (hepatitis, liver cirrhosis), connective tissue diseases, acute and chronic infections, as well as in the cord blood of neonates with intrauterine and perinatal infections.

2. Elevation of immunoglobulin M may occur in monoclonal gammopathies such as macroglobulinemia, primary systemic amyloidosis, monoclonal gammopathy of undetermined significance, and related disorders."

If subsequent tests bear out the presence of monoclonal IgM, then some of the disorders in #2 may apply and then the article below would be relevant.

J Mikhael, "Ask the Hematologist: A Diagnostic Approach to Patients with an IgM monoclonal protein", The Hematologist, Sep 15, 2014 (full text of article)

I'm not a doc, but I think you need to first eliminate the potential non-monoclonal IgM causes (those listed in #1 above) since your electrophoresis test registered no monoclonal protein (even though your IgM level is pretty high) and your immunofixation test only detected a "faint band" ... and you have some other issues going on with your kidneys, liver, etc.

There a lot of Canadians on this forum and they can suggest places to seek out top hematologists, including those that are expert in multiple myeloma and related disorders. You might want to let folks know what part of Canada you live in. Hope this helps.

[Julie23]

Re: Faint ill-defined band of IgM, type kappa, detected

by Julie23 on Tue Mar 15, 2016 9:33 am

Hi Multibilly,

Thank you so much for taking the time to answer my question. You have really helped me out a lot!

I am so anxious that I have to wait until May 16 to see a hematologist. I live in Toronto, Canada. I don't know why the blood test comment said to re-test in 6-12 months. I feel that I need to try to get to the bottom of this issue before then. Just in case it is something that requires early treatment.

Thanks again Multibilly. I would love to hear back from anyone and everyone who has info on this topic.

[Little Monkey]

Re: Faint ill-defined band of IgM, type kappa, detected

by Little Monkey on Fri Mar 18, 2016 1:24 pm

Is your haematologist appointment going to be Princess Margaret Hospital or one of the community hospitals?

Your haematologist will likely request a bunch of tests on the appointment day; if you are sent to Princess Margaret, it will be a half-a-day event where you will be 95 percent likely to do blood tests before you even see the haematologist. Your next blood text will likely be far sooner than 6-12 months.

Princess Margaret Hospital and London Health Sciences have their special units which just deal with plasma cell disorders.

Not to alarm you, but if you don't have pharmaceutical insurance through work, apply for the Trillium health plan now via the Ministry of Health; there is no charge, nor do you need a reason to apply for it and ALL Ontarians are eligible for it. Trillium pays for all medicines after your pharmacy bills hit higher than 4% of your household income.

In the case the haematologist prescribes some treatment to be injected inside a hospital, it is covered by OHIP regardless what pharma-plan you are on.

I'm hoping the blood test results was just some sort of fluke which happens here and there.

[Julie23]

Re: Faint ill-defined band of IgM, type kappa, detected

by Julie23 on Fri Apr 15, 2016 1:10 pm

Hi Little Monkey,

Thank you for your well wishes and great advice!

I was referred to a hem/onc at North York general hospital. I am under my boyfriend's work health insurance plan. Can I still apply for the Trillium health plan?

I hope to get to the bottom of this soon.

Take care,

Julie

[Little Monkey]

Re: Faint ill-defined band of IgM, type kappa, detected

by Little Monkey on Fri Apr 15, 2016 1:45 pm

Yes, Julie, anyone whose insurance does not cover 100% of all pharmacy rival costs can receive Trillium plan assistance.

[Julie23]

Re: Faint ill-defined band of IgM, type kappa, detected

by Julie23 on Mon Apr 18, 2016 12:22 pm

Thank you, Little Monkey!

[Little Monkey]

Re: Faint ill-defined band of IgM, type kappa, detected

by Little Monkey on Tue Apr 19, 2016 12:53 pm

Sorry, that should be "pharmaceutical" not "pharmacy rival".

Other provinces have similar programs.

I advise all Ontarioans in a rough spot to register for the program, it's free and you want it to kick in at the right time if needed.