[lmazzi]

Kappa & lambda levels elevated, but ratio is normal

by lmazzi on Wed Oct 28, 2015 11:45 am

New here and I need help with these results. My appointment is not for another 2 weeks and I don't understand what this means if anything.

Protein, Total, Serum 6.6 6.0-8.5 g/dL
Gamma Globulin 1.1 0.5-1.6 g/dL
Beta Globulin 0.9 0.6-1.3 g/dL
Alpha-2-Globulin 0.9 0.4-1.2 g/dL
Alpha-1-Globulin 0.3 0.1-0.4 g/dL
Albumin 3.4 3.2-5.6 g/dL
Globulin, Total 3.2 2.0-4.5 g/dL
A/G Ratio 1.1 0.7-2.0 1

M-Spike: Not Observed Not Observed

Immunofixation Result, Serum
An apparent polyclonal gammopathy: IgM. Kappa and lambda typing
appear increased.

Immunoglobulin G, Qn, Serum 947 700-1600 mg/dL
Immunoglobulin A, Qn, Serum 383 91-414 mg/dL
Immunoglobulin M, Qn, Serum 254 40-230 mg/dL

Free Kappa Lt Chains,S 34.81 3.30-19.40 mg/L
Free Lambda Lt Chains,S 29.22 5.71-26.30 mg/L
Kappa/Lambda Ratio,S 1.19 0.26-1.65 1

From what I have read, if both lights are high and the ratio is low, it means no myeloma, but looking at it scares me. Can anyone tell me what could cause both to be high?

Thanks so much.

[Cheryl G]

Re: Kappa & lambda levels elevated, but ratio is normal

by Cheryl G on Wed Oct 28, 2015 10:11 pm

Hello lmazzi,

You don't have any signs of multiple myeloma or a related plasma cell disorder. You have no measurable M-spike (monoclonal protein) on your serum protein electrophoresis, and your serum immunofixation also is not picking up any signs of a monoclonal protein. Monoclonal proteins are hallmarks of plasma cell disorders such as myeloma. People without a plasma cell disorder do not have monoclonal proteins -- they only have polyclonal blood proteins.

You most likely have either an infection or an autoimmune disorder that is causing your IgM and both of your free light chain levels to be elevated without the ratio being elevated. To me -- and I'm not a physician -- the fact that your IgM is elevated suggests that infection is the more likely the cause.

The table in this posting in the forum can be helpful in interpreting free light chain results. Your results are interpreted as suggesting "Polyclonal Ig [immunoglobulin] increase or renal impairment". I lean toward the "polyclonal immunoglobulin increase" explanation because you in fact have an elevated immunoglobulin, IgM.

You should discuss these results further with your doctors, but based on the results you've shared, it really doesn't look like you have myeloma or anything similar to it.

Good luck!

[Ron Harvot]

Re: Kappa & lambda levels elevated, but ratio is normal

by Ron Harvot on Thu Oct 29, 2015 2:14 pm

I second everything that Cheryl posted. I would, however, want to rule out any renal impairments.

Did you have a full chemistry panel run? If so, what were the creatinine levels and BUN and ratio numbers? If those are normal, then renal impairment can likely be ruled out.

Ron

[lmazzi]

Re: Kappa & lambda levels elevated, but ratio is normal

by lmazzi on Mon Nov 02, 2015 7:00 pm

Thank you so much Cheryl and Ron for your response.

I haven't seen my hematologist yet. My blood work for 2 years have been off wack and my primary finally said I should see a hematologist. I've been telling them for such a long time there is no reason i should feel so ill and white blood count has been high for those 2 years and they say "well your blood is always off" So this time I insisted to see a specialist and the specialist assured me he will find out what is wrong as to why I feel so ill.

Ron - Thank you as well. Yes he did run a full panel and nothing seems to be off except a few things that I am not sure what they mean. I have posted them below and I finally am scheduled for an appointment for this Friday.

WBC 12.7 High
RBC 5.37 High
Hemoglobin 10.6
Hematocrit 36.
MCV 69 Low
MCH 19.7 Low
MCHC 28.8 Low
RDW 18.6 High
Platelets 480 High
Neutrophils 69
Lymphs 25
Monocytes 5
Eos 1
Basos 0

Neutrophils (Absolute) 8.7 High
Lymphs (Absolute) 3.1 x10E3/uL 0.7 - 3.1 02
Monocytes(Absolute) 0.7 x10E3/uL 0.1 - 0.9 02
Eos (Absolute) 0.1 x10E3/uL 0.0 - 0.4 02
Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2 02
Immature Granulocytes 0 % 02
Immature Grans (Abs) 0.0

Thank you all so much. I wish you all the best of luck.

[Ron Harvot]

Re: Kappa & lambda levels elevated, but ratio is normal

by Ron Harvot on Tue Nov 03, 2015 4:46 pm

What you have posted are results of the complete blood count (CBC). What I was referring to was the chemistry panel. It measures things like creatinine, glucose, BUN, protein, etc.

I do note on your CBC that you have high platlets, White Cells and your absolute Neutrophil count is high. Have you had any recent illness - infections? Not a Dr. but those are not something that most multiple myeloma see. Generally those with multiple myeloma have issues with low white counts, neutrophil and platelets sometimes due to the treatments. Not sure your readings mean anything but those coupled with the high light chains (but normal) ratio appear to point to something other than multiple myeloma as a reason.

Hope your Friday appointment goes well and answers your questions.