[njm1120]

Kappa & lambda free light chains high, ratio normal

by njm1120 on Mon Jul 18, 2016 8:45 pm

Hello,

I was diagnosed with IgG lambda MGUS in October 2010 with an average M-spike of 0.50 g/dL (5 g/L). My numbers have been stable ever since.

However, in my last two tests (December 2015 and July 2016), both my kappa and lambda serum free light chain levels were slightly elevated. I would expect my lambda free light chain level to be elevated slightly, but I don't understand why the kappa free light chain level would be elevated.

My most recent numbers are:

Kappa - 2.50 H (Ref. range 0.33 - 1.94)
Lambda - 3.47 H (Ref. range 0.57 - 2.63)
Normal Ratio

My kidney function is normal, and I don't have any inflammatory conditions that I am aware of. Does anyone know if this is something I should be concerned about?

Thank you.

[Multibilly]

Re: Kappa & lambda free light chains high, ratio normal

by Multibilly on Tue Jul 19, 2016 6:49 am

Hmmm. Renal impairment or a polyclonal increase due to inflammation, etc are the typical explanations for simultaneously high kappa and lambda values that are accompanied by a normal ratio. But you already understand that.

Note this article for possible inflammatory and autoimmune causes:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3564472/

"Increased free light chain concentrations have been described in a variety of inflammatory and autoimmune diseases including systemic lupus erythematosus, rheumatoid arthritis, Sjögren’s syndrome, atopic dermatitis, asthma, rhinitis, food allergy, idiopathic pulmonary fibrosis, hypersensitivity pneumonitis, chronic obstructive pulmonary disease (COPD), inflammatory bowel disease and multiple sclerosis"

But neither your kappa or lambda are very high, so I don't know if I would necessarily leap to any of the above explanations. In any case, a rheumatologist is likely in the best position to help you out here. Let us know what you decide to do and find out.