[bad blood]

IgG lambda MGUS with frequent infections - why?

by bad blood on Tue Oct 29, 2013 9:02 am

I have some questions about my SPEP results and hope someone can shed some light on my ongoing issues.

A quick recap of the last 8 months. I am IgG lambda mgus. Since last March I have been dealing with ongoing infections that have been taking up to 3 doses of antibiotics each time to clear them up. I have only been off them for a couple weeks and I am sick again!

I am also having episodes of low body temps/hypothermia. CBC did not expain my issues. My SPEP: Kappa low (3.3), kappa/lambda ratio (0.25) My m-spike never has changed.

What is causing all my issues? Thanks for your time. I manage to stump everyone.

[Dr. Jason Valent]

Re: IgG lambda MGUS with frequent infections - why?

by Dr. Jason Valent on Wed Oct 30, 2013 4:21 pm

It would help to know what your total immunoglobulin levels are in this case. The M-protein will account for some of the IgG in your blood. (example is M-protein 1.0 g/dL; total IgG 1700 mg/dL; then your "healthy" IgG is 700).

If the "healthy" portion of the IgG is low, you may benefit from supplemental IV IgG administration. If serious / life threatening infections are occurring, there is also an argument to start multiple myeloma therapy for that reason.

Ask your doctor about IgG levels and how much of that is abnormal and how much is normal.

[bad blood]

Re: IgG lambda MGUS with frequent infections - why?

by bad blood on Thu Oct 31, 2013 11:03 am

Thank you Dr,
My spep..IgG 1020, 1gM 84, 1gA 151 Total protein 6.9 (6.2-8.3) That does not explain my infections either. I do have hypocellular marrow. Would that be the cause?

[Kay]

Re: IgG lambda MGUS with frequent infections - why?

by Kay on Fri Nov 01, 2013 1:07 am

I am IgG Lambda MGUS with an M Spike of 0.2g/dL; IgG: 589 mg/dL; IgM: 73 mg/dL and IgA: 88 mg/dL; K/Lr: 0.09 and like “bad blood” have had continuous sinus and upper respiratory infections that started in August 2012. After the first couple rounds of antibiotics, cultures were done to determine the appropriate antibiotics. I ended up having 2 sinus debridements, under anesthesia, to clean out maxillary sinus and have done saline irrigations with antibiotic and steroid in the mix plus some oral antibiotics continuously since late December. I stopped the antibiotics about a month ago, still using saline and steroid irrigation, saw ENT this week and the sinus is OK but on oral antibiotics again for upper respiratory. I’ve discussed IVIG with hematologist but it appeared that I was gradually improving (on antibiotics), so we held off on the IVIG. I also have a consistent below normal absolute lymphocyte level due to interferon beta 1b injections for MS. Time to check IgG sub-classes for IVIG therapy - or other suggestions?

Thanks, Kay