HI!
A couple of months ago I had a routine blood test that came back with an IgG kappa paraprotein of 8 g/l. Also slightly abnormal serum free light chain ratio. I am copying this from a letter from a haematologist.
It's all a bit confusing to me. I ma not sure if my GP is quite unclear about this field or it is her job to play things down.
Ultimately I fall into the category of 1% risk of transformation into myeloma, according to this letter.
My first question is does everyone have a level of kappa paraprotein in their blood? Is there a normal range?
I had the test redone after 2 months and was told everything was back to normal. But on asking for a copy of my results my kappa paraprotein, it is still 8 g/l. My first results have details of the serum free light ratios only, it is in the letter that it mentions the 8 g/l. My latest results have no info on the serum light ratios, just the same paraprotein level of 8g/l.
I am a bit confused!
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Re: IgG kappa paraprotein - is it something normal?
Hi Webby01,
Welcome to the forum.
Allow me to try to clarify a few things.
Most patients that present with MGUS or myeloma produce both a monoclonal version of a "heavy chain immunoglobulin," such as IgG, and a monoclonal version of a "light chain immunoglobulin," such as the kappa light chain.
You have an "M-spike" (paraprotein level) of 8 g/L (in the USA, this would normally be expressed as 0.8 g/dL). This means that your blood has a concentration of 8 g/L of monoclonal IgG heavy chain protein. It is not not normal to have have any monoclonal IgG protein in one's blood, but it is normal to have quite a bit of polylconal (normal) IgG in your blood. An m-spike level of 8 g/L may suggest you have a condition such as MGUS if it continues to show up in your bloodwork
Additionally, you are also producing monoclonal kappa free light chains since your immunofixation test also stated that you have an "IgG kappa" M-spike. It's normal to have some non-monoclonal (polyclonal) kappa and lambda free light chains floating around in your blood, but it is not normal to have any monoclonal free light chains present in your blood. The way you verify if your serum free light chain values are out of whack and may contain a component of monoclonal free light chains is to go back and look at your serum free light chain assay test and compare your lab numbers to normal levels. Normal free light chains levels are as following:
Kappa: 3.3-19.4 mg/L
Lambda: 5.71-26.3 mg/L
Ratio: .26-1.65
If you haven't had a serum free light chain assay yet, you should request one, along with a a quantified immunoglobulin test that measures your total IgG, IgA and IgM levels. You should also be asking for a comprehensive metabolic panel and CBC lab test.
In any case, I would strongly urge you to contact a hematologist that specializes in myeloma to run more complete tests. If you let us know where you live, folks on this forum can make some recommendations as to where to find these specialists. Hope this helps a bit.
Welcome to the forum.
Allow me to try to clarify a few things.
Most patients that present with MGUS or myeloma produce both a monoclonal version of a "heavy chain immunoglobulin," such as IgG, and a monoclonal version of a "light chain immunoglobulin," such as the kappa light chain.
You have an "M-spike" (paraprotein level) of 8 g/L (in the USA, this would normally be expressed as 0.8 g/dL). This means that your blood has a concentration of 8 g/L of monoclonal IgG heavy chain protein. It is not not normal to have have any monoclonal IgG protein in one's blood, but it is normal to have quite a bit of polylconal (normal) IgG in your blood. An m-spike level of 8 g/L may suggest you have a condition such as MGUS if it continues to show up in your bloodwork
Additionally, you are also producing monoclonal kappa free light chains since your immunofixation test also stated that you have an "IgG kappa" M-spike. It's normal to have some non-monoclonal (polyclonal) kappa and lambda free light chains floating around in your blood, but it is not normal to have any monoclonal free light chains present in your blood. The way you verify if your serum free light chain values are out of whack and may contain a component of monoclonal free light chains is to go back and look at your serum free light chain assay test and compare your lab numbers to normal levels. Normal free light chains levels are as following:
Kappa: 3.3-19.4 mg/L
Lambda: 5.71-26.3 mg/L
Ratio: .26-1.65
If you haven't had a serum free light chain assay yet, you should request one, along with a a quantified immunoglobulin test that measures your total IgG, IgA and IgM levels. You should also be asking for a comprehensive metabolic panel and CBC lab test.
In any case, I would strongly urge you to contact a hematologist that specializes in myeloma to run more complete tests. If you let us know where you live, folks on this forum can make some recommendations as to where to find these specialists. Hope this helps a bit.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: IgG kappa paraprotein - is it something normal?
Thanks you so much for taking the time to reply to me.
I was originally referred to a haematologist after my first results. They then reviewed my results and decided it wasn't necessary to see them at this point and that I should be monitored at my GP's.
My serum free light chain results from my original test were as follows:
Serum kappa light chain 30.4 mg/l
Serum lambda light chain 9.48 mg/l
Serum kappa: lambda light chain 3.207
I then had some tests done after two months and was told everything was normal.
They didn't seem to test for serum free light chains the second time.
The recent tests were just for paraprotein and immunoglobulins.
My serum paraprotein level is still 8 g/l . It says on the results 'tell patient normal,' which is where i'm confused.
My IgG, IgM and IgA are all within normal levels.
I was originally referred to a haematologist after my first results. They then reviewed my results and decided it wasn't necessary to see them at this point and that I should be monitored at my GP's.
My serum free light chain results from my original test were as follows:
Serum kappa light chain 30.4 mg/l
Serum lambda light chain 9.48 mg/l
Serum kappa: lambda light chain 3.207
I then had some tests done after two months and was told everything was normal.
They didn't seem to test for serum free light chains the second time.
The recent tests were just for paraprotein and immunoglobulins.
My serum paraprotein level is still 8 g/l . It says on the results 'tell patient normal,' which is where i'm confused.
My IgG, IgM and IgA are all within normal levels.
Re: IgG kappa paraprotein - is it something normal?
Hi Webby01,
Sounds like you aren't from the USA.
From the numbers you've posted, it sounds like you indeed have MGUS. But a doctor obviously needs to make that official diagnosis. Note that your free light chain numbers are not especially worrisome and are consistent with a diagnosis of MGUS. The standard practice for MGUS is to periodically monitor the patient with blood tests, which definitely could be done by a GP. I would push for being retested in 6 months or so - a year at the latest.
Not sure who is saying "tell patient normal" when it is very likely you have MGUS. I guess that's between you and the author of that message.
Sounds like you aren't from the USA.
From the numbers you've posted, it sounds like you indeed have MGUS. But a doctor obviously needs to make that official diagnosis. Note that your free light chain numbers are not especially worrisome and are consistent with a diagnosis of MGUS. The standard practice for MGUS is to periodically monitor the patient with blood tests, which definitely could be done by a GP. I would push for being retested in 6 months or so - a year at the latest.
Not sure who is saying "tell patient normal" when it is very likely you have MGUS. I guess that's between you and the author of that message.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: IgG kappa paraprotein - is it something normal?
I'm from the UK.
Basically, my GP has just been very bad at explaining it to me. The letter I have from the haematologist does suggest MGUS.
I will be having tests every 6 months.
Thanks again for putting my mind at rest. It was just a little hard at first seeing the words myeloma in black and white. My GP never even mentioned it. I guess sometimes it's better not to know!
Basically, my GP has just been very bad at explaining it to me. The letter I have from the haematologist does suggest MGUS.
I will be having tests every 6 months.
Thanks again for putting my mind at rest. It was just a little hard at first seeing the words myeloma in black and white. My GP never even mentioned it. I guess sometimes it's better not to know!
5 posts
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