Hello everyone,
I'm a 46-year-old man. I was diagnosed with Type 2 diabetes last fall, and there was concern about the amount of protein and micro blood in my urine.
My primary care doctor referred me to a nephrologist. He recently called me to say my test results show my kidneys are functioning as they should, but the protein I'm throwing in my urine is mostly an "M-protein," and that I should see a hematologist as soon as possible.
I've since gone on the Internet and learned, with regret, what this could mean.
I can't get in to the hematologist for something like two weeks, and as a result, I'm kind of freaking myself out looking at this stuff via the Internet.
Anyway, here's a question perhaps someone can help me with: My urine test results state the following: "Complexed IgG Kappa monoclonal heavy chain protein present. Result has been confirmed by immunofixation."
But from everything I read, it seems unusual to me that the heavy chain protein would be present but no light chain. Am I wrong?
What could this mean?
Thanks.
Forums
6 posts
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Re: Heavy chain protein present in urine - but not light cha
Do you know what test was done for you? There is not only a 'serum free light chain' test, which measures the ratio of kappa/lambda proteins that have detached from the monoclonal antibodies being produced by myeloma or ameloidosis. There is a 'heavy/light' test also, which measures the ration between whole antibodies (e.g. IGg/iGa). So the 'heavy chain' may be a reference to the whole antibody molecule, not just the chains free floating! Both of these tests are very sensitive and are both from the same company (the Binding Site).
Hope you don't have multiple myeloma, though! You probably will have some questions about the tests when you return to the doctor. I must be nerve wracking waiting on results..take care!
Hope you don't have multiple myeloma, though! You probably will have some questions about the tests when you return to the doctor. I must be nerve wracking waiting on results..take care!
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Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
Re: Heavy chain protein present in urine - but not light cha
Sorry, you did say this test was by 'immunofixation'. I still think that 'heavy chain' must refer to whole antibodies, rather than light chains. Light chains are measured by the SFLC testing as I mentioned.
IGg kappa would refer to the type of monoclonal protein.
Even if you have 'M' protein, you still might not have myeloma. You might have MGUS (monoclonal gammopathy of undetermined significance), which does not necessarily progress to myeloma. Or there is an intermediary condition, SMM, where the disease is 'smoldering' but still not necessarily going to progress to myeloma. Lots to learn about this, that;s for sure. Hope that helps.
IGg kappa would refer to the type of monoclonal protein.
Even if you have 'M' protein, you still might not have myeloma. You might have MGUS (monoclonal gammopathy of undetermined significance), which does not necessarily progress to myeloma. Or there is an intermediary condition, SMM, where the disease is 'smoldering' but still not necessarily going to progress to myeloma. Lots to learn about this, that;s for sure. Hope that helps.
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Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
Re: Heavy chain protein present in urine - but not light cha
Yes, it definitely helps. Thanks for taking the time to respond.
It still seems odd to me that they made mention of heavy chains but not light chains if there were indeed light chains present.
But as you say, there's a lot to learn and I don't really understand any of this yet.
If it must be something, I'm hoping for MGUS but I'm ready to fight whatever the diagnosis.
Based on multiple sources, the hematologist I'm visiting is one of the best in the state. I just hope the days between now and my appointment pass quickly.
It still seems odd to me that they made mention of heavy chains but not light chains if there were indeed light chains present.
But as you say, there's a lot to learn and I don't really understand any of this yet.
If it must be something, I'm hoping for MGUS but I'm ready to fight whatever the diagnosis.
Based on multiple sources, the hematologist I'm visiting is one of the best in the state. I just hope the days between now and my appointment pass quickly.
Re: Heavy chain protein present in urine - but not light cha
Just in case anybody else ever wonders about this, I think I've figured it out. The key word in what they said about my urine test finding is "complexed," which based on my reading here:
http://en.wikipedia.org/wiki/Antibody
... I take to mean as a heavy chain formed with a light chain. With the IgG referring to the heavy chain and the Kappa to the light chain.
I'll double-check with the hematologist when I get a chance.
http://en.wikipedia.org/wiki/Antibody
... I take to mean as a heavy chain formed with a light chain. With the IgG referring to the heavy chain and the Kappa to the light chain.
I'll double-check with the hematologist when I get a chance.
Re: Heavy chain protein present in urine - but not light cha
Dear Motown Kiko,
A normal intact antibody has a heavy chain, which can be IgG, IgA or IgM (and on rare occasion IgD or IgE), complexed with a kappa or lambda light chain. An IgG kappa monoclonal antibody was found on your urine protein electrophoresis and immuofixation. That means that there are kappa light chains there -- but they are complexed to a heavy chain (IgG). The monoclonal antibody that was found is an intact antibody consisting of an IgG heavy chain and kappa light chain. There are no free kappa light chains in your urine.
Hopefully this just represents MGUS. It is important for your kidney doctor and hematologist to not only rule out multiple myeloma, but to ensure that this monoclonal IgG kappa is not a sign of any other related disorder that can affect the kidneys, such as amyloidosis or monoclonal immunoglobulin deposition disease.
We see a lot of patients with similar circumstances, and the most common diagnosis we encounter is MGUS.
Let us know how things go with your hematologist or if you have any other questions.
Take care!
Pete V.
A normal intact antibody has a heavy chain, which can be IgG, IgA or IgM (and on rare occasion IgD or IgE), complexed with a kappa or lambda light chain. An IgG kappa monoclonal antibody was found on your urine protein electrophoresis and immuofixation. That means that there are kappa light chains there -- but they are complexed to a heavy chain (IgG). The monoclonal antibody that was found is an intact antibody consisting of an IgG heavy chain and kappa light chain. There are no free kappa light chains in your urine.
Hopefully this just represents MGUS. It is important for your kidney doctor and hematologist to not only rule out multiple myeloma, but to ensure that this monoclonal IgG kappa is not a sign of any other related disorder that can affect the kidneys, such as amyloidosis or monoclonal immunoglobulin deposition disease.
We see a lot of patients with similar circumstances, and the most common diagnosis we encounter is MGUS.
Let us know how things go with your hematologist or if you have any other questions.
Take care!
Pete V.
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Dr. Peter Voorhees - Name: Peter Voorhees, M.D.
Beacon Medical Advisor
6 posts
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