[jjnyc]

Kappa / lambda ratio from random urine test

by jjnyc on Tue Dec 15, 2015 4:13 pm

I've been considering going for a second opinion about my MGUS based on recent results. I have lived with MGUS for the last 9 years. As of November, the SPEP shows a normal kappa / lambda ratio and no M protein was identified in the 24-hour urine. However, a random urine (performed before the 24-hour urine) showed an abnormal kappa / lambda ratio of 17.00 (range 2.04-10.37). My hematologist told me that the SPEP and the 24-hour urine were better indicators and she seemed to completely dismiss the random urine. She told me I could be re-tested in a year.

This was about a month ago and I can't shake the anxiety about this. Any insights would be appreciated.

[Multibilly]

Re: Kappa / lambda ratio from random urine test

by Multibilly on Tue Dec 15, 2015 4:56 pm

To be clear, an SPEP gives you an M-spike value. A serum free light chain assay gives you the serum kappa / lambda free light chain ratio.

24-hour urine free light chain measurements are quite unreliable. Random urine samples even more so. Serum free light chain assay measurements are far more reliable than any urine test. I'm not a doc, but I would go with your doc's recommendation.