Hello,
I recently received my blood test results and need help understanding what it all means since the spectrum can vary significantly.
I am a 39 year old male who was seen for a lipid panel. After looking at my results, these "other tests" showed up online. These included SPEP panel, Immunofixation, and free light chains serum. Having no idea what these were or mean.
I was looking around and came across this forum. Would someone be able to look at these and help me understand what they mean. I have a follow-up visit with a hematologist, but that isn't for another 2 months. Wondering if I should find another doctor sooner than that to help me explain these results, as my PCP doesn't seem to know. The PCP then ordered a CBC and those results look to be all within standard range.
Thanks in advance,
Cos
RESULTS
IMMUNOFIXATION
There is a 0.27 g/dl IgA kappa M component in the beta region.
Serum free kappa light chains are increased.
Serum free kappa/lambda light chain ratio is normal.
Component Your Value Standard Range
Kappa Free Lt Chain 36.3 mg/L 3.3-19.4 mg/L
Lambda Free Lt Chain 21.5 mg/L 5.7-26.3 mg/L
Kappa-lambda ratio 1.69 0.30-1.70
Component Your Value Standard Range
Total Prot 7.6 g/dL 6.0-8.3 g/dL
IgG 1052 mg/dL 614-1295 mg/dL
IgA 1019 mg/dL 69-309 mg/dL
IgM 79 mg/dL 53-334 mg/dL
SPEP Abnormal pattern
Banding present.
Please see Immunofixation for final results.
Normal SPEP: Normal pattern
CBC RESULTS
Component Your Value Standard Range
WBC 8.19 K/uL 4.5-11.0 K/uL
RBC 5.17 M/uL 4.50-5.90 M/uL
HGB 14.7 g/dL 13.5-17.5 g/dL
HCT 43.8 % 41.0-53.0 %
PLT 242 K/uL 150-400 K/uL
MCV 84.7 fL 80.0-100.0 fL
MCH 28.4 pg 26.0-34.0 pg
MCHC 33.6 g/dL 31.0-37.0 g/dL
RDW 12.9 % 11.5-14.5 %
MPV 10.8 fl 8.4-12.0 fl
NRBC 0.00 /100 0-0.20 /100 WBCs
ABS NRBC 0.00 K/uL 0-0.01 K/uL
DIFF METH Auto
NEUTS 57.1 % 40-70 %
LYMPHS 31.6 % 22-44 %
MONOS 8.8 % 4-11 %
EOS 1.2 % 0-8 %
BASOS 0.9 % 0-3 %
%IMMAT GRNS 0.4 % 0.0-0.9 %
ABS NEUTS 4.68 K/uL 1.8-7.7 K/uL
ABS LYMPHS 2.59 K/uL 1.0-4.8 K/uL
ABS MONOS 0.72 K/uL 0.2-1.2 K/uL
ABS EOS 0.10 K/uL 0.0-0.9 K/uL
ABS BASOS 0.07 K/uL 0.0-0.3 K/uL
ABS IMMAT
GRANS 0.03 K/uL 0.00-0.10 K/uL
Forums
8 posts
• Page 1 of 1
Re: Kappa M component in beta region - meaning?
Hi cos13,
Welcome to the forum.
Do you know what caused your doctor to order all of these tests in the first place? Was there an elevated protein or globulin count on an earlier metabolic panel test or were you experiencing some bone pain or something else out of the ordinary? I ask because it's not normal to order these tests unless there is a suspicion of some sort of plasma cell disorder or related disease. If you have the results of an earlier metabolic panel test, it would be helpful if you posted those results as well.
Keeping in mind that I'm not a doctor, an small IgA M-spike of 0.27 g/dL and a slightly elevated kappa free light chain (FLC) "may" suggest an early stage of MGUS. MGUS is not something one normally treats and the risk of it progressing to something like symptomatic multiple myeloma is only on the order of 1.5 - 2%/ year.
With these very mild M-spike and kappa FLC levels, along with with a normal FLC ratio, waiting a couple of months to see a hematologist should not be a concern (unless you are experiencing some symptom such as bone pain, etc). However, while not absolutely essential with MGUS, I would recommend seeking out a hematologist that specializes in myeloma to evaluate these numbers and to suggest any follow-up tests and ongoing screening tests. I say this because not all hematologists routinely see myeloma patients and it pays to work with a specialist that understands all the nuances of this disease and works with many myeloma patients on a daily basis. If you let us know where you live, folks on this site can likely make some recommendations as to where to find a myeloma specialist.
Hope this helps a bit.
Welcome to the forum.
Do you know what caused your doctor to order all of these tests in the first place? Was there an elevated protein or globulin count on an earlier metabolic panel test or were you experiencing some bone pain or something else out of the ordinary? I ask because it's not normal to order these tests unless there is a suspicion of some sort of plasma cell disorder or related disease. If you have the results of an earlier metabolic panel test, it would be helpful if you posted those results as well.
Keeping in mind that I'm not a doctor, an small IgA M-spike of 0.27 g/dL and a slightly elevated kappa free light chain (FLC) "may" suggest an early stage of MGUS. MGUS is not something one normally treats and the risk of it progressing to something like symptomatic multiple myeloma is only on the order of 1.5 - 2%/ year.
With these very mild M-spike and kappa FLC levels, along with with a normal FLC ratio, waiting a couple of months to see a hematologist should not be a concern (unless you are experiencing some symptom such as bone pain, etc). However, while not absolutely essential with MGUS, I would recommend seeking out a hematologist that specializes in myeloma to evaluate these numbers and to suggest any follow-up tests and ongoing screening tests. I say this because not all hematologists routinely see myeloma patients and it pays to work with a specialist that understands all the nuances of this disease and works with many myeloma patients on a daily basis. If you let us know where you live, folks on this site can likely make some recommendations as to where to find a myeloma specialist.
Hope this helps a bit.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Kappa M component in beta region - meaning?
Hi Multibilly,
Thanks for your reply. I'm located in Boston and will be seeing a hematologist in the Mass General hematology-oncology department, and they do have several myeloma specialists, so that is assuring.
To answer your question about what caused the doctor to order the test, I'll need to find that out (I was confused too), but I was initially being followed for abnormal HDL (low) and LDL (low) for a few years but might have to consider this a blessing in disguise that this test was ordered!? I currently do not have any of the symptoms that I've read (fatigue, bone pain, etc), so maybe they felt that 2 months out was appropriate.
As far as prior tests that were done, all those metabolic tests have been in the standard range since I began tracking these since 2010, and specifically globulin has been anywhere from 2.9 to 3.4 with a standard range of 1.9-4.1, and a total protein anywhere from 7.3 to 8.6 with a range of 6-8.3, and the most recent protein result from the other day of 7.6 total protein, so I think that's why I'm confused since the total protein and CBC tests came back OK.
I don't see any metabolic test, so I may request a new one (the most recent was in February) to see if anything major has changed since then. It was the SPEP panel, Immunofixation, and free light chains serum tests that were are so confusing to interpret, but your response helped me out tremendously.
I will post a followup to this once I have more information. Thank you and have a great day!
-Cos
Thanks for your reply. I'm located in Boston and will be seeing a hematologist in the Mass General hematology-oncology department, and they do have several myeloma specialists, so that is assuring.
To answer your question about what caused the doctor to order the test, I'll need to find that out (I was confused too), but I was initially being followed for abnormal HDL (low) and LDL (low) for a few years but might have to consider this a blessing in disguise that this test was ordered!? I currently do not have any of the symptoms that I've read (fatigue, bone pain, etc), so maybe they felt that 2 months out was appropriate.
As far as prior tests that were done, all those metabolic tests have been in the standard range since I began tracking these since 2010, and specifically globulin has been anywhere from 2.9 to 3.4 with a standard range of 1.9-4.1, and a total protein anywhere from 7.3 to 8.6 with a range of 6-8.3, and the most recent protein result from the other day of 7.6 total protein, so I think that's why I'm confused since the total protein and CBC tests came back OK.
I don't see any metabolic test, so I may request a new one (the most recent was in February) to see if anything major has changed since then. It was the SPEP panel, Immunofixation, and free light chains serum tests that were are so confusing to interpret, but your response helped me out tremendously.
I will post a followup to this once I have more information. Thank you and have a great day!
-Cos
Re: Kappa M component in beta region - meaning?
Let us know what you find out.
Mass General has several myeloma specialists, so it's great that you are following up there. Dr. Noopur Raje (who heads up their myeloma team) is quite active in various research projects involving myeloma.
Mass General has several myeloma specialists, so it's great that you are following up there. Dr. Noopur Raje (who heads up their myeloma team) is quite active in various research projects involving myeloma.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Kappa M component in beta region - meaning?
Hi Multibilly,
I just got my comprehensive metabolic panel results back (below) and those appear to all be in the standard range. I'm curious to know what the doctor says in October and will post back.
Thanks again for your insight!
-Mark
Component Your Value Standard Range
SODIUM 1 41 mmol/L 135-145 mmol/L
POTASSIUM 3.9 mmol/L 3.4-5.0 mmol/L
CHLORIDE 101 mmol/L 98-108 mmol/L
CO2 23 mmol/L 23-32 mmol/L
BUN 17 mg/dL 8-25 mg/dL
CREATININE 0.98 mg/dL 0.60-1.50 mg/dL
GLUCOSE 86 mg/dL 70-110 mg/dL
ALBUMIN 4.5 g/dL 3.3-5.0 g/dL
TOTAL PROT 7.7 g/dL 6.0-8.3 g/dL
CALCIUM 9.7 mg/dL 8.5-10.5 mg/dL
ALK PHOS 59 U/L 45-115 U/L
TOT BILIRUB. 0.8 mg/dL 0.0-1.0 mg/dL
AST 21 U/L 10-40 U/L
ALT (U/L) 16 U/L 10-55 U/L
GLOBULIN 3.2 g/dL 1.9-4.1 g/dL
ANION GAP 17 mmol/L 3-17 mmol/L
EGFR: >60 mL/min/1.73m2
The normal range for eGFR is >60 mL/min/1.73m2.
I just got my comprehensive metabolic panel results back (below) and those appear to all be in the standard range. I'm curious to know what the doctor says in October and will post back.
Thanks again for your insight!
-Mark
Component Your Value Standard Range
SODIUM 1 41 mmol/L 135-145 mmol/L
POTASSIUM 3.9 mmol/L 3.4-5.0 mmol/L
CHLORIDE 101 mmol/L 98-108 mmol/L
CO2 23 mmol/L 23-32 mmol/L
BUN 17 mg/dL 8-25 mg/dL
CREATININE 0.98 mg/dL 0.60-1.50 mg/dL
GLUCOSE 86 mg/dL 70-110 mg/dL
ALBUMIN 4.5 g/dL 3.3-5.0 g/dL
TOTAL PROT 7.7 g/dL 6.0-8.3 g/dL
CALCIUM 9.7 mg/dL 8.5-10.5 mg/dL
ALK PHOS 59 U/L 45-115 U/L
TOT BILIRUB. 0.8 mg/dL 0.0-1.0 mg/dL
AST 21 U/L 10-40 U/L
ALT (U/L) 16 U/L 10-55 U/L
GLOBULIN 3.2 g/dL 1.9-4.1 g/dL
ANION GAP 17 mmol/L 3-17 mmol/L
EGFR: >60 mL/min/1.73m2
The normal range for eGFR is >60 mL/min/1.73m2.
Re: Kappa M component in beta region - meaning?
Just wanted to follow up on this thread from August / September.
I saw the doctors over at MGH and they ran several tests (actually quite a lot; see below). They said given my M-spike of 0.27, I did not have MGUS, because the definition he said was 0.40 or higher. But anyways, an M-spike is present, so they're attempting to get to the bottom of it. The test that jumped out was a positive AB for gliadin (gluten), which is weird because I don't have any symptoms of that. They are going to follow up in 6 months to see if anything changes but at this point he said I don't need to do anything at this time. Still concerns me though. Well, I guess I will just need to watch this closely.
Thanks and have a great day!
-Cos13
Total complement
Tissue transglutaminase IgG
Comprehensive metabolic panel
Anti-mitochondrial antibody
IgA kappa/lambda (Hevylite IgA)
IgM kappa/lambda (Hevylite IgM)
Beta-2 microglobulin, blood
Free light chains, serum
Tissue transglutaminase IgA
Thyroperoxidase (TPO) antibodies
Complement C4
Complement C3
Gliadin IgG and IgA antibodies
Celiac serology
Rheumatoid factor
Antinuclear antibody (ANA)
C-Reactive Protein
Reticulocytes
Sedimentation rate (ESR)
Special slide box
CBC and differential
IgA kappa/lambda (Hevylite IgA) - Details
IgA 935 mg/dL 69 - 309 mg/dL
IgA (kappa) 871 mg/dL 65 - 310 mg/dL
IgA (lambda) 58 mg/dL 45 - 213 mg/dL
IgA (kappa/lambda) 15.02 0.95 - 2.21
Anti Gliadin IGG AB 1.09 U/mL 0 - 15 U/mL
Negative
Anti Gliadin IGA AB 24.11 U/mL 0 - 15 U/mL
Positive
I saw the doctors over at MGH and they ran several tests (actually quite a lot; see below). They said given my M-spike of 0.27, I did not have MGUS, because the definition he said was 0.40 or higher. But anyways, an M-spike is present, so they're attempting to get to the bottom of it. The test that jumped out was a positive AB for gliadin (gluten), which is weird because I don't have any symptoms of that. They are going to follow up in 6 months to see if anything changes but at this point he said I don't need to do anything at this time. Still concerns me though. Well, I guess I will just need to watch this closely.
Thanks and have a great day!
-Cos13
Total complement
Tissue transglutaminase IgG
Comprehensive metabolic panel
Anti-mitochondrial antibody
IgA kappa/lambda (Hevylite IgA)
IgM kappa/lambda (Hevylite IgM)
Beta-2 microglobulin, blood
Free light chains, serum
Tissue transglutaminase IgA
Thyroperoxidase (TPO) antibodies
Complement C4
Complement C3
Gliadin IgG and IgA antibodies
Celiac serology
Rheumatoid factor
Antinuclear antibody (ANA)
C-Reactive Protein
Reticulocytes
Sedimentation rate (ESR)
Special slide box
CBC and differential
IgA kappa/lambda (Hevylite IgA) - Details
IgA 935 mg/dL 69 - 309 mg/dL
IgA (kappa) 871 mg/dL 65 - 310 mg/dL
IgA (lambda) 58 mg/dL 45 - 213 mg/dL
IgA (kappa/lambda) 15.02 0.95 - 2.21
Anti Gliadin IGG AB 1.09 U/mL 0 - 15 U/mL
Negative
Anti Gliadin IGA AB 24.11 U/mL 0 - 15 U/mL
Positive
Re: Kappa M component in beta region - meaning?
Huh, so how weird is that? So, your increased IgA level on your HevyLite test results is being explained by your anti gliadin IgA number? I don't know much about celiac disease, but are they going to do any further testing to see if you might in fact have celiac disease?
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Kappa M component in beta region - meaning?
Hi Multibilly,
I asked to doctor if the positive result for anti gliadin IgA AB is the reason on why the IgA kappa / lambda (Hevylite IgA) test is so high or the reason for the IgA M-spike or we still don't know?
Also, I asked him if the celiac serology confirmed whether or not I have celiac disease?
Doctor's response:
These tests are interesting but not conclusive – it is possible that much of the elevated IgA (that which is not the spike) is related to celiac problems. You don't clinically appear to have any symptoms of celiac disease but it would be of interest to know what happens to these antibodies if you went on a gluten free diet.
That is an experiment that we might consider.
More to come on this when I get my 2nd set of blood tests again in the spring.
Thanks and happy holidays!
Cos13
I asked to doctor if the positive result for anti gliadin IgA AB is the reason on why the IgA kappa / lambda (Hevylite IgA) test is so high or the reason for the IgA M-spike or we still don't know?
Also, I asked him if the celiac serology confirmed whether or not I have celiac disease?
Doctor's response:
These tests are interesting but not conclusive – it is possible that much of the elevated IgA (that which is not the spike) is related to celiac problems. You don't clinically appear to have any symptoms of celiac disease but it would be of interest to know what happens to these antibodies if you went on a gluten free diet.
That is an experiment that we might consider.
More to come on this when I get my 2nd set of blood tests again in the spring.
Thanks and happy holidays!
Cos13
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