Last year I went to a doctor for low testosterone. Only because I thought I had low testosterone. I told him that I was not feeling on top of my game and that my dad had celiac.
Well, he order a complete panel of like everything. The lab bill was like 1500.00 dollars. Covered by insurance thankfully.
Everything turned out fine and I did not have low testosterone.
Except I had an elevated IgA levels. He was perplexed by this and had me see a hematologist immediately.
I did not know these doctors usually work at the cancer centers so, when I called, I kind of freaked out and started to think I had cancer.
In any rate, the hematologist looked at me after seeing my results and just look at me like I was dumb and why am I not all enjoying my life and why are you acting like all hypochondriac like. I was kind of offended but I did not say anything.
So far I have had like 5 complete blood work tests done. I did not feel comfortable with this doctor entirely so I went back to my primary doctor which I have two of them and they both ran complete tests.
All test come back fine except that I have elevated IgA mainly and a little elevated IgM.
I even went to an allergist certified doctor which told me that clinically that elevated IgA means nothing.
My primary doctor says that is what just makes you, you. That these results are based on a bell curve and that sometimes people are outliers. Is this true in my case?
Questions:
What does elevated IgA mean exactly?
What does elevated IgM mean exactly?
What does “An apparent polyclonal gammopathy: IgA and IgM. Kappa and lambda typing appear increased.” mean exactly?
What does “The SPE pattern appears essentially unremarkable. Evidence of monoclonal protein is not apparent.” mean exactly?
Is this anything I should worry about or do I just simply ignore this and move on with my life?
Does this have anything to with allergies or chronic sinusitis possibly? Because I have read up on this and have found that it might be do to that and I do have bad sinuses.
If everything is fine now, can everything stay fine or does this mean I can develop “multiple myeloma” or some form of “cancer” in the future based on these results? I mean, I know everyone has a chance of getting cancer. I am just wondering if I have an increased chance or something based on these results.
I am asking this because it just doesn’t seem like any of my doctors either are not really concerned by this, or just don’t really know what to make of it. I wish they could just tell me exactly what it is and what I should either prepare for or not prepare for.
I have seen the following doctors:
Two primary doctors
One hematologist
Allergist
Endocrinologist
And have also had an ultrasound and a CT scan of my pelvis and stomach because I believe I have IBS instead of celiac disease like my father.
So please let me know what I should do or what I should know.
Results:
2014 – March
Immunoglobulin A, Qn, Serum 710 High mg/dL 91 − 414 01
Endomysial Antibody IgA Negative Negative 01
2014 – April
Beta Globulin 1.4 High g/dL 0.6 − 1.3 01
Immunoglobulin A, Qn, Serum 721 High mg/dL 91 − 414 01
Immunoglobulin M, Qn, Serum 271 High mg/dL 40 − 230 01
THE SPE PATTERN APPEARS ESSENTIALLY UNREMARKABLE. EVIDENCE OF MONOCLONAL PROTEIN IS NOT APPARENT.
2014 – October
Beta Globulin 1.4 High g/dL 0.6 - 1.3 01
Immunoglobulin A, Qn, Serum 753 High mg/dL 91 - 414 01
Immunoglobulin M, Qn, Serum 270 High mg/dL 40 - 230 01
P E Interpretation, S 01 The SPE pattern appears essentially unremarkable. Evidence of
monoclonal protein is not apparent.
I have the two from my primary doctor but they just say elevated IgA and they are not worried about it.
All of these blood tests have much more information and tests on them but they are all normal so I didn’t bother putting them up here.
I am just wondering if my doctors are not telling me something because they do not want to get me down or depressed. By telling me that this can turn into something or is it truly something not to worry about?
I have seen many doctors. Do any of you know of anyone else that I can go to that can truly tell me what these results mean?
Also can you explain to me where I can post these results to where I can get some answers and also do you know anything about these results?
Thank you for your time and I greatly appreciate your feedback.
Forums
Re: High IgA & IgM levels - precursors to multiple myeloma?
Just to let you know that I am not a doctor, but will comment only on the SPE results. When it says that, "there is no evidence of monoclonal protein present", this is good. In myeloma the results usually say "that there is evidence of a monoclonal protein and that there is paresis noted", or words to that effect. I don't know what it means that the IgA and the IgM are increased.
Maybe someone more knowledgeable here in the forum will respond better to your questions. If not, see if you can ask a myeloma specialist near you to take a look at your blood test results and give you an opinion. You may have to pay for the review of your results, but it may be worth it.
Good luck to you in getting the answers to the questions that you are asking,
Nancy in Phila
Maybe someone more knowledgeable here in the forum will respond better to your questions. If not, see if you can ask a myeloma specialist near you to take a look at your blood test results and give you an opinion. You may have to pay for the review of your results, but it may be worth it.
Good luck to you in getting the answers to the questions that you are asking,
Nancy in Phila
-
NStewart - Name: Nancy Stewart
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 3/08
- Age at diagnosis: 60
Re: High IgA & IgM levels - precursors to multiple myeloma?
Thank you for taking the time to comment.
Yes I might have to seek additional advice from another professional. Maybe I can look for one that you suggested.
Yes I might have to seek additional advice from another professional. Maybe I can look for one that you suggested.
Re: High IgA & IgM levels - precursors to multiple myeloma?
Your IgA level is very elevated. While your IgM level is outside the normal range, it's not as dramatically outside the reference range as your IgA level.
The fact that signs of a monoclonal protein were consistently absent from your serum electrophoresis tests on at least two sets of tests suggests that the issue is not some kind of myeloma-related disease (MGUS, smoldering myeloma, or multiple myeloma).
If you really want to have it confirmed, you could have a serum immunofixation electrophoresis performed. I don't see that in your test results.
There apparently are a very large number of things that can cause elevated IgA levels aside from a disease related to myeloma. See this extended discussion and references for some additional ideas:
http://www.aaaai.org/ask-the-expert/levated-IgA-with-no-explanation.aspx
I agree with Nancy that it wouldn't hurt to go see a myeloma specialist, or have a myeloma specialist review your results. It probably would settle the issue of whether you have anything myeloma-related once and for all.
But, at this point, you should know that it doesn't look like you have anything of that sort.
Good luck and please let us know what you find out as you learn more.
The fact that signs of a monoclonal protein were consistently absent from your serum electrophoresis tests on at least two sets of tests suggests that the issue is not some kind of myeloma-related disease (MGUS, smoldering myeloma, or multiple myeloma).
If you really want to have it confirmed, you could have a serum immunofixation electrophoresis performed. I don't see that in your test results.
There apparently are a very large number of things that can cause elevated IgA levels aside from a disease related to myeloma. See this extended discussion and references for some additional ideas:
http://www.aaaai.org/ask-the-expert/levated-IgA-with-no-explanation.aspx
I agree with Nancy that it wouldn't hurt to go see a myeloma specialist, or have a myeloma specialist review your results. It probably would settle the issue of whether you have anything myeloma-related once and for all.
But, at this point, you should know that it doesn't look like you have anything of that sort.
Good luck and please let us know what you find out as you learn more.
-
JimNY
Re: High IgA & IgM levels - precursors to multiple myeloma?
Needspractice,
Jim and Nancy's comments seem spot on. I would be discussing with the doctor what your high IgA could mean given that this does not appear to be a form of monoclonality.... which as Nancy says, is "good news".
Something like bacterial sinusitis is a much preferred diagnosis in comparison to multiple myeloma.
Best of luck with this and let us know how things turn out.
Jim and Nancy's comments seem spot on. I would be discussing with the doctor what your high IgA could mean given that this does not appear to be a form of monoclonality.... which as Nancy says, is "good news".
Something like bacterial sinusitis is a much preferred diagnosis in comparison to multiple myeloma.
Best of luck with this and let us know how things turn out.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: High IgA & IgM levels - precursors to multiple myeloma?
JimNY,
I agree my IGA level does seem very elevated. I did have the immunofixation electrophoresis done as well which shows on my lab results.
That section is where it says:
Immunofixation, Serum
Immunofixation Result, Serum An apparent polyclonal gammopathy: IgA and IgM. Kappa and lambda typing appear increased.
Then
The SPE pattern appears essentially unremarkable. Evidence of P E Interpretation, S
monoclonal protein is not apparent.
I have already found that link and read it through. I appreciate you looking though. I have read the answer several times and it just seems like the guy is beating around the bush and really doesn’t know what to answer.
“bacterial sinusitis” – I believe has to be the absolute best cause because literally I have bad sinuses to the point that sometimes my nose is crusted with icky dark stuff. It comes and goes but maybe I have a bacteria infection in my sinus area that I have been fighting for a long time?
Myeloma specialist - I would even know where to find one? And why hasn’t my hematologist recommended that? I mean I see my Hematologist next week and I promise you they are barely going to speak or give me any answers. It’s the weirdest thing. I will be there but then I won’t be.
Multibilly,
You wrote:
Ya, I would prefer that as well but how do I get that confirmed. Even in that article the man states that there is no literature backing up that it is bacterial sinusitis.
I agree my IGA level does seem very elevated. I did have the immunofixation electrophoresis done as well which shows on my lab results.
That section is where it says:
Immunofixation, Serum
Immunofixation Result, Serum An apparent polyclonal gammopathy: IgA and IgM. Kappa and lambda typing appear increased.
Then
The SPE pattern appears essentially unremarkable. Evidence of P E Interpretation, S
monoclonal protein is not apparent.
I have already found that link and read it through. I appreciate you looking though. I have read the answer several times and it just seems like the guy is beating around the bush and really doesn’t know what to answer.
“bacterial sinusitis” – I believe has to be the absolute best cause because literally I have bad sinuses to the point that sometimes my nose is crusted with icky dark stuff. It comes and goes but maybe I have a bacteria infection in my sinus area that I have been fighting for a long time?
Myeloma specialist - I would even know where to find one? And why hasn’t my hematologist recommended that? I mean I see my Hematologist next week and I promise you they are barely going to speak or give me any answers. It’s the weirdest thing. I will be there but then I won’t be.
Multibilly,
You wrote:
Something like bacterial sinusitis is a much preferred diagnosis in comparison to multiple myeloma.
Ya, I would prefer that as well but how do I get that confirmed. Even in that article the man states that there is no literature backing up that it is bacterial sinusitis.
Re: High IgA & IgM levels - precursors to multiple myeloma?
Also, do you think I have it's MGUS? Or has this been ruled out by my blood tests?
Or
Bacteria sinusitis or some kind of infection or allergy that my body has been trying to fight off for over a year?
Here are a couple of links to where people having elevated IgA and the doctors really have no idea what to make of it when no others symptoms are present.
http://www.aaaai.org/ask-the-expert/levated-IgA-with-no-explanation.aspx
http://www.aaaai.org/ask-the-expert/recurrent-respiratory-infection.aspx
Any other ideas or ways to go? I have a feeling when I see my hematologist next week they are just going to say, looks like your results are fine, good luck be safe out there, will run a follow up next year.
That’s it with no explanation.
I just find it hard to believe that in 2014 that is the best we can do with blood tests.
Or
Bacteria sinusitis or some kind of infection or allergy that my body has been trying to fight off for over a year?
Here are a couple of links to where people having elevated IgA and the doctors really have no idea what to make of it when no others symptoms are present.
http://www.aaaai.org/ask-the-expert/levated-IgA-with-no-explanation.aspx
http://www.aaaai.org/ask-the-expert/recurrent-respiratory-infection.aspx
Any other ideas or ways to go? I have a feeling when I see my hematologist next week they are just going to say, looks like your results are fine, good luck be safe out there, will run a follow up next year.
That’s it with no explanation.
I just find it hard to believe that in 2014 that is the best we can do with blood tests.
Re: High IgA & IgM levels - precursors to multiple myeloma?
I apologize. I meant to also ask:
Do I have “Polyclonal Gammopathy of Unknown Significance”, or is this even possible?
This is what my blood test says:
Immunofixation, Serum
01
Immunofixation Result, Serum
An apparent polyclonal gammopathy: IgA and IgM. Kappa and lambda typing appear increased.
Result:
P E Interpretation, S
01
The SPE pattern appears essentially unremarkable. Evidence of monoclonal protein is not apparent.
It doesn’t mention anything of “monoclonal” just “polyclonal”
That is why I was wondering if this possibly existed:
Polyclonal Gammopathy of Unknown Significance
or when:
“The SPE pattern appears essentially unremarkable. Evidence of monoclonal protein is not apparent.”
Cancels all this out …
Do you understand what I am trying to say?
Do I have “Polyclonal Gammopathy of Unknown Significance”, or is this even possible?
This is what my blood test says:
Immunofixation, Serum
01
Immunofixation Result, Serum
An apparent polyclonal gammopathy: IgA and IgM. Kappa and lambda typing appear increased.
Result:
P E Interpretation, S
01
The SPE pattern appears essentially unremarkable. Evidence of monoclonal protein is not apparent.
It doesn’t mention anything of “monoclonal” just “polyclonal”
That is why I was wondering if this possibly existed:
Polyclonal Gammopathy of Unknown Significance
or when:
“The SPE pattern appears essentially unremarkable. Evidence of monoclonal protein is not apparent.”
Cancels all this out …
Do you understand what I am trying to say?
Re: High IgA & IgM levels - precursors to multiple myeloma?
Once you get into discussions of polyclonal gammopathies, you're getting into areas that aren't really the expertise of people here. MGUS, smoldering myeloma, and multiple myeloma are monoclonal gammopathies most of the time. When it comes to figuring out what the cause of polyclonal gammopathies might be, I suspect you're going to have to get advice somewhere else.
This is a good initial source to start understanding differences between monoclonal and polyclonal gammopathies:
O'Connell,T.X. et al., "Understanding and Interpreting Serum Protein Electrophoresis," American Family Physician, Jan 1, 2005 (full text)
You'll see that it says the following:
This Mayo study discusses some of the usual diagnoses associated with polyclonal gammopathies:
A Dispenzieri et al., "Retrospective cohort study of 148 patients with polyclonal gammopathy," Mayo Clinic Proceedings, May 2001 (abstract)
You can find summaries of the study at these two links:
http://www.mayomedicallaboratories.com/media/articles/communique/mar2002.pdf
http://www.wikilite.com/wiki/index.php/Classification_of_diseases_with_increased_immunoglobulins
and it's also discussed (along with some other insights) by a physician here:
http://www.aaaai.org/ask-the-expert/asymptomatic.aspx
In general, these sources suggest that either liver disease or a group of conditions known as "connective tissue diseases" seem like the most likely candidates. If the source of a problem is an infection, then it could resolve itself with time.
My sense is that you should discuss your blood test results some more with your primary care physician first, perhaps sharing with them some of the results of your research (in a way that is going to be easy for them to digest quickly). Since you don't seem to be showing symptoms that are sending up major warning flags, both of you may decide to wait 6 months and then run some blood tests again. That would seem a reasonable plan to me.
If you happen to track down the source of the polyclonal gammopathy at some point, I'd certain be interested to know what it is and how it was determined.
Good luck!
This is a good initial source to start understanding differences between monoclonal and polyclonal gammopathies:
O'Connell,T.X. et al., "Understanding and Interpreting Serum Protein Electrophoresis," American Family Physician, Jan 1, 2005 (full text)
You'll see that it says the following:
It is extremely important to differentiate monoclonal from polyclonal gammopathies. Monoclonal gammopathies are associated with a clonal process that is malignant or potentially malignant. In contrast, polyclonal gammopathies may be caused by any reactive or inflammatory process, and they usually are associated with nonmalignant conditions."
This Mayo study discusses some of the usual diagnoses associated with polyclonal gammopathies:
A Dispenzieri et al., "Retrospective cohort study of 148 patients with polyclonal gammopathy," Mayo Clinic Proceedings, May 2001 (abstract)
You can find summaries of the study at these two links:
http://www.mayomedicallaboratories.com/media/articles/communique/mar2002.pdf
http://www.wikilite.com/wiki/index.php/Classification_of_diseases_with_increased_immunoglobulins
and it's also discussed (along with some other insights) by a physician here:
http://www.aaaai.org/ask-the-expert/asymptomatic.aspx
In general, these sources suggest that either liver disease or a group of conditions known as "connective tissue diseases" seem like the most likely candidates. If the source of a problem is an infection, then it could resolve itself with time.
My sense is that you should discuss your blood test results some more with your primary care physician first, perhaps sharing with them some of the results of your research (in a way that is going to be easy for them to digest quickly). Since you don't seem to be showing symptoms that are sending up major warning flags, both of you may decide to wait 6 months and then run some blood tests again. That would seem a reasonable plan to me.
If you happen to track down the source of the polyclonal gammopathy at some point, I'd certain be interested to know what it is and how it was determined.
Good luck!
-
JimNY
Re: High IgA & IgM levels - precursors to multiple myeloma?
JimNY,
WoW.
How in the world did you find all that great information. I have been looking for months and you found it in like a day.
This gives me a lot more information to go on and will be reading it all. Thank you.
On the other hand I still find it sad that I will not be able to really identify what this is. I have a feeling that I will see my doctor next week and they are not going to know either.
I wonder if I could find a doctor that is willing to investigate all of these different disorders and see if I have any?
Do you think they should do this or wait to see if I develop any symptoms?
WoW.
How in the world did you find all that great information. I have been looking for months and you found it in like a day.
This gives me a lot more information to go on and will be reading it all. Thank you.
On the other hand I still find it sad that I will not be able to really identify what this is. I have a feeling that I will see my doctor next week and they are not going to know either.
I wonder if I could find a doctor that is willing to investigate all of these different disorders and see if I have any?
Do you think they should do this or wait to see if I develop any symptoms?
Last edited by needspractice on Sun Oct 19, 2014 10:17 am, edited 1 time in total.
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