Can these lab values indicate myeloma?
Immunofixation result in serum gave:
Elevated Immunoglobulin G at 3376 mg/dL ,
Elevated Immunoglobulin A = 530 mg/dL.
Immunoglobulin M gave 141 mg/dL [normal range 40-230mg/dL].
Lab results summary stated "an apparent polychlonal gammopathy: IgG and IgA. Kappa and Lambda typing appear increased".
I'm age 60 and have sjogrens. My albumin level is normal as are blood metabolic panel for TSH, kidney and liver function. Also normal values for CBC-differential and hemoglobin A1c. I have background morning sinus congestion [since my teens] and a persisting tongue sore that started 2 years ago. Since May of 2013, sporadically get 2 millimeter size painful petechia on legs that last only 1 week, then fade and disappear.
What other tests should be done to detect myeloma?
Ginny
Forums
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Re: lab tests for myeloma
First off, I'm not a doc, so please double check this with a multiple myeloma specialist.
Usually, in multiple myeloma, only one of your immunoglobulins is elevated. In your case, both your IgG and IgA are elevated. This may not be related to multiple myeloma, but that is not for certain. In about 1% of multiple myeloma cases, you can have two different immunoglobulins that are elevated, which is what you have going on. So, it could be what is known as a bi-clonal gammopathy. As I understand it, true polyclonal gammopathies are not caused by myeloma, but are instead caused by inflammation, etc. I really don't know anything about sjogrens, but a quick google of "sjogrens + polyclonal" shows that polyclonal gammopathies are not uncommon for those that have the disease, so that may simply be the explanation.
To be sure about the multiple myeloma, you should get all the laboratory tests indicated below, including the bone imaging (full body Xray or full body MRI). It's good you don't appear to have anemia or kidney issues, but you need to rule out any any bone involvement through the imaging. A bone marrow biopsy can definitively tell you what's going on if multiple myeloma is involved.
https://myeloma.org/ArticlePage.action?tabId=1&menuId=322&articleId=3177&aTab=-1
Again, I'm not a doc, so I suggest you verify this all with a hematologist. But, it sort of sounds like sjogrens is the culprit here?
Usually, in multiple myeloma, only one of your immunoglobulins is elevated. In your case, both your IgG and IgA are elevated. This may not be related to multiple myeloma, but that is not for certain. In about 1% of multiple myeloma cases, you can have two different immunoglobulins that are elevated, which is what you have going on. So, it could be what is known as a bi-clonal gammopathy. As I understand it, true polyclonal gammopathies are not caused by myeloma, but are instead caused by inflammation, etc. I really don't know anything about sjogrens, but a quick google of "sjogrens + polyclonal" shows that polyclonal gammopathies are not uncommon for those that have the disease, so that may simply be the explanation.
To be sure about the multiple myeloma, you should get all the laboratory tests indicated below, including the bone imaging (full body Xray or full body MRI). It's good you don't appear to have anemia or kidney issues, but you need to rule out any any bone involvement through the imaging. A bone marrow biopsy can definitively tell you what's going on if multiple myeloma is involved.
https://myeloma.org/ArticlePage.action?tabId=1&menuId=322&articleId=3177&aTab=-1
Again, I'm not a doc, so I suggest you verify this all with a hematologist. But, it sort of sounds like sjogrens is the culprit here?
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Lab tests for myeloma
Probably not. Polyclonal hypergammaglobulinemia is common in autoimmune conditions such as Sjogren's.
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Dr. Jason Valent - Name: Jason Valent, M.D.
Beacon Medical Advisor
3 posts
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