[Joe V]

Low lambda and low kappa FLC levels - cause?

by Joe V on Fri Sep 05, 2014 11:01 am

Hi all!

My name is Joe, I am 21, and I have a few questions.

I was diagnosed with severe small fiber neuropathy in April of this year, and since then, I have ruled out just about every cause. Most recently I was tested for amyloidosis by my neurologist. During the testing the doctor found some abnormalities in one of my blood tests. I had testing for free light chains.

Lambda Free, Serum- 4.8 mg/L
Normal range- 5.7-26.3 mg/L

Kappa Free, Serum- <3.3 mg/L
Normal range- 3.3-19.4 mg/L

K/L Ratio, Serum- <0.69
Normal range- 0.26-1.65

I assume my K/L ratio would have been lower, had they been able to measure the Kappa any lower.

I also had monoclonal protein blood, and monoclonal protein urine, tests. Both tests showed no abnormalities with Ig, and no sign of any M protein.

After talking with my doctor, she said she is pretty sure she has ruled out amyloidosis, but did not mention anything about the abnormal test (through email, so I could not ask).

My question to you guys is, what do you think?

I have done a lot of research on this forum, but I can't seem to find much information on low levels of lambda and kappa free light chains.

Should I go see a Hematologist?

I also have a chiari malformation, and a lot of gastro/upper G.I problems, if that means anything.

Thank you,
Joe V

[Multibilly]

Re: Low lambda and low kappa FLC levels - cause?

by Multibilly on Fri Sep 05, 2014 1:29 pm

Joe,

This might give you a clue to chase:

"Free Light Chain Question," Beacon forum discussion started August 21, 2012 (includes posting by Beacon Medical Advisor Dr. Peter Voorhees).

[Dr. Jonathan Kaufman]

Re: Low lambda and low kappa FLC levels - cause?

by Dr. Jonathan Kaufman on Sat Sep 06, 2014 4:15 pm

Joe, it is important to make sure that you have had all of the testing that you need on the tests you have already completed. Make sure that you have had immunofixation of both the serum and the urine protein tests.

It is not uncommon to have low immunoglobulins. It does not appear that you have an abnormality. In general, I don't think the low ratio is important if one of the light chains is not elevated.

I would consider repeating the serum free light chain. In addition, I don't know if they have already checked, but they can assess for amyloidosis on a skin biopsy when they make the diagnosis of small fiber neuropathy.

And I agree with Multibilly, look at the post from Dr. Voorhees.

My best,

Jlk

[Joe V]

Re: Low lambda and low kappa FLC levels - cause?

by Joe V on Sun Sep 07, 2014 11:26 am

Thank you both very much for your replies.

I will most likely make an appointment with a hematologist, just for good measures.

Again, thank you.