Hello,
I have been seeing a haematologist since last August 2017. I've seen him twice because blood tests kept coming back with high WBC and low red bloods. Kept getting water infections aching all over like flu; bones, arms, upper neck/back, and lower back and hips. Feel like tooth ache in them, not nice. Have fibromyalgia for a few years now but this seem different I think.
Anyway, had some results back
Kappa level 39.64 mg/l
Lambda level 7.35 mg/l
Kappa/lambda ratio 5.393
Do these results mean I have MGUS?
MGUS is mentioned on the results with amyloidosis, This is why i was sent to a specialist.
Second lot of tests showed free light chains high but a little lower than the ones above. Also
IgG 5.64 g/l
IgA 0.58 g/l
IgM 0.32 g/l
Decreased gamma globulins - no paraprotein detected
Serum total protein 72 g/l
Serum albumin 39 g/l
Serum globulin 33 g/l
Specialist says we are monitoring you, too early to say exactly what it could be. Next appointment is in July.
Thank you in advance.
Forums
7 posts
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chelle151 - Name: michelle
- Who do you know with myeloma?: no one
- When were you/they diagnosed?: have not yet
Re: Lab report says possible MGUS
Hi Michelle,
Welcome to the forum.
It would be helpful if you listed the reference ranges for each of the lab values you listed. But the major thing that jumps out at me is that no paraprotein was detected. What will be key is whether they also ran an "immunofixation" test and what the results of that test were. The immunofixation test will tell you if your excess kappa level is monoclonal (cancerous) in nature and therefore whether MGUS or amyloidosis might be in play.
The "no paraprotein detected" comment looks to be from a serum electrophoresis test and only tells you that you have no measurable monoclonal immunoglobulins (IgG, IgA, IgM). But that electrophoresis test doesn't rule out the possibility that you may have monoclonal free light chains.
Without knowing your reference ranges, it would appear that all of your immunoglobulins (IgG, IgA, IgM) may also be suppressed. This is a condition known as immunoparesis and can be a result of either MGUS or amyloidosis.
It's curious that "amyloidosis" was mentioned as a possibility at this stage. Did you have a 24-hour urine test, or any sort of tissue biopsy. or are your exhibiting some symptoms that would have led the pathologist to suggest that as a possibility?
Welcome to the forum.
It would be helpful if you listed the reference ranges for each of the lab values you listed. But the major thing that jumps out at me is that no paraprotein was detected. What will be key is whether they also ran an "immunofixation" test and what the results of that test were. The immunofixation test will tell you if your excess kappa level is monoclonal (cancerous) in nature and therefore whether MGUS or amyloidosis might be in play.
The "no paraprotein detected" comment looks to be from a serum electrophoresis test and only tells you that you have no measurable monoclonal immunoglobulins (IgG, IgA, IgM). But that electrophoresis test doesn't rule out the possibility that you may have monoclonal free light chains.
Without knowing your reference ranges, it would appear that all of your immunoglobulins (IgG, IgA, IgM) may also be suppressed. This is a condition known as immunoparesis and can be a result of either MGUS or amyloidosis.
It's curious that "amyloidosis" was mentioned as a possibility at this stage. Did you have a 24-hour urine test, or any sort of tissue biopsy. or are your exhibiting some symptoms that would have led the pathologist to suggest that as a possibility?
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Lab report says possible MGUS
Hi Multibilly,
Thank you for replying. This is everything I think.
Serum total 72 g/l (60-80)
Serum albumin 39 g/l (35-50)
Serum globulin 33 g/l (22-43)
IgG 5.64 g/l (6.00- 16.00)
IgA 0.58 g/l (0.80- 2.80)
IgM 0.32 g/l (0.50- 1.90)
Says "light chain level" antigen excess causes some immunoassays to underestimate very high concentrations of antigen, significant light chain abnormality light chain MGUS amyloidosis and other light chain disorders possible. See haematologist.
Serum kappa light chain level 39.64 mg/l (3.30-19.40)
Serum lambda light chain level 7.35 mg/l (5.70-26.30)
Kappa: lambda ratio light chain 5.393 mg/l (0.260- 1.650)
Suggested Bence-Jones urine test, not had results yet.
But for about a year I have had protein levels in urine tests every month Not had a 24-hour urine test yet.
Okay, think that's everything I can tell you for now.
Thank you for helping me.
Thank you for replying. This is everything I think.
Serum total 72 g/l (60-80)
Serum albumin 39 g/l (35-50)
Serum globulin 33 g/l (22-43)
IgG 5.64 g/l (6.00- 16.00)
IgA 0.58 g/l (0.80- 2.80)
IgM 0.32 g/l (0.50- 1.90)
Says "light chain level" antigen excess causes some immunoassays to underestimate very high concentrations of antigen, significant light chain abnormality light chain MGUS amyloidosis and other light chain disorders possible. See haematologist.
Serum kappa light chain level 39.64 mg/l (3.30-19.40)
Serum lambda light chain level 7.35 mg/l (5.70-26.30)
Kappa: lambda ratio light chain 5.393 mg/l (0.260- 1.650)
Suggested Bence-Jones urine test, not had results yet.
But for about a year I have had protein levels in urine tests every month Not had a 24-hour urine test yet.
Okay, think that's everything I can tell you for now.
Thank you for helping me.
-
chelle151 - Name: michelle
- Who do you know with myeloma?: no one
- When were you/they diagnosed?: have not yet
Re: Lab report says possible MGUS
OK, so I would recommend that you ask the doctor for a serum immunofixation test and a 24-hour urine test (also known as a Bence-Jones urine test) the next time you get tested. That will help narrow down the possibilities of why your IgG, IgA, IgM and kappa free light chain levels are out of whack.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Lab report says possible MGUS
Hi,
Thank you for the quick reply. Very helpful. I will do that.
Thanks,
Michelle
Thank you for the quick reply. Very helpful. I will do that.
Thanks,
Michelle
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chelle151 - Name: michelle
- Who do you know with myeloma?: no one
- When were you/they diagnosed?: have not yet
Re: Lab report says possible MGUS
Hi Michelle,
You may also wish to request that your IgD level be tested. It's rare to measure a person's IgD, but doing so could help narrow things down.
The reason I mention this is I have IgD multiple myeloma. During my initial diagnosis (2011), the IgG, IgA, and IgM levels were suppressed (below the normal range).
Take Care
You may also wish to request that your IgD level be tested. It's rare to measure a person's IgD, but doing so could help narrow things down.
The reason I mention this is I have IgD multiple myeloma. During my initial diagnosis (2011), the IgG, IgA, and IgM levels were suppressed (below the normal range).
Take Care
Re: Lab report says possible MGUS
Hi Anon25,
Thanks for the tip. I will look into it. Hope you're ok, or at least feeling better.
Michelle
Thanks for the tip. I will look into it. Hope you're ok, or at least feeling better.
Michelle
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chelle151 - Name: michelle
- Who do you know with myeloma?: no one
- When were you/they diagnosed?: have not yet
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