[andywellis2013]

Lab Results

by andywellis2013 on Fri Dec 06, 2013 12:33 pm

Hi, I am new to this forum and do not have a diagnosis. I just wanted to receive some inputs before I see my doctor again in weeks. Here is my information:

I am a 46-year-old male, overall feeling healthy, but starting 1 year ago, catching cold/coughing frequently, consistently having mild low back pain and trace protein in urine. My doctor put me on lab testing, and here are the results:

Blood:
SPEP: normal pattern
IgG: normal
IgA: 368 (normal range 69-309), out of range
IgM: normal
Serum free light chains: normal
Kappa free light chains: normal
Lamba free light chains: normal
Kappa FLC/Lamba FLC: normal

Urine:
Bence-Jones Protein: Not detected.
Kappa free light chains: 56.7 (normal range 0.4-15.1), out of range
Lamba free light chains: normal
Kappa FLC/Lamba FLC: 22.7 (normal range 0.5-4.0), out of range

Could this be multiple myeloma; or if not, what could it be? Any thoughts are really appreciated.

Andy

[dnalex]

Re: Lab Results

by dnalex on Fri Dec 06, 2013 4:04 pm

Hi Andy,

I think that just from looking at the blood work, it's not possible to make a definitive conclusion, and other tests will be needed such as MRI, as well as looking at other parameters in the blood. It does look like that you have slightly higher IgA antibody and higher kappa light chain paraprotein in the blood, which alters the ratio of the kappa to lamda light chain.

Are you scheduled for more tests?

Best wishes,
Alex

[andywellis2013]

Re: Lab Results

by andywellis2013 on Fri Dec 06, 2013 4:53 pm

Hi, Alex,

Thanks for your response. If you look into the results again, you can see that my blood results were normal except for mildly increased IgA, and my urine kappa free long chains levels were increased.

Andy

[Multibilly]

Re: Lab Results

by Multibilly on Fri Dec 06, 2013 7:59 pm

It sounds like you had many of the standard multiple myeloma blood and serum tests done already. For good measure, one typically does a full skeletal xray survey to look for lytic lesions in your bones. The golden test for multiple myeloma would be a bone marrow biopsy.

You also want to be looking at your your calcium and hemaglobin levels, creatinine, Beta2 Microglobulin, BUN and albumin levels (you probably have all these if you have the results of the other tests you mention). These will give you clues if you are meeting any of the C,R or A (calicum, renal, anemia) issues in the C.R.A.B. criteria to see if you are symptomatic. The xray will tell you if you have any of the B issues in C.R.A.B.

You really need to have the results of these other tests to figure out just what is going on. It could be a very early and benign stage of multiple myeloma such as MGUS that will never progress to multiple myeloma.

Best of luck to you.

[andywellis2013]

Re: Lab Results

by andywellis2013 on Tue Dec 10, 2013 11:18 pm

I am still very confused. I post the values here and hopefully can receive some more feedback.

Results in Blood:

SPEP: normal pattern
IgG: 1255 (normal range 614-1295)
IgA: 368 (normal range 69-309), out of range
IgM: 118 (53-334)
Serum free light chains: normal
Kappa free light chains: 10.3 ((normal range 3.3-19.4)
Lamba free light chains: 14.8 ((normal range 5.7-26.3)
Kappa FLC/Lamba FLC: 0.7 ((normal range 0.3-1.7)

Results in Urine:

Bence-Jones Protein: Not detected in 50x concentrated urine.
Kappa free light chains: 56.7 (normal range 0.4-15.1), out of range
Lamba free light chains: 2.5 ((normal range 0.8-10.1)
Kappa FLC/Lamba FLC: 22.7 (normal range 0.5-4.0), out of range

I have two questions:

1) Can serum kappa free light chains be normal, but urine kappa free light chains be elevated? I remember Dr. Voorhees said that the serum free light chain test is more sensitive than the urine free light chain test, but also read in another post that this could happen because there is a Bence-Jones type multiple myeloma.

2) Regarding my urine results, can my Bence-Jones protein test be negative, but urine kappa light chains be elevated? My understanding is that Bence-Jones detects the light-chains also, so why the results are conflicting?

Thanks very much!

Andy