[SCruze]

Neurologist found M band in blood test

by SCruze on Thu Oct 16, 2014 5:01 pm

Hello.

So now forward to the oncologist with the current condition of MGUS. I don't like that And now the obligatory CBC where everything is in normal range (cheer).

Next the comprehensive metabolic panel. Results all normal save the glucose, which is just a little high. Calcium is 9 mg/dL and that's good to see.

Then there's the Other test, which includes Immunoglobulin G.M.A. G being slightly below norm, but only just. So, more normal. AST/SGOT is 65 U/L, should be 15 to 37. ATL/SGPT is 65 U/L,should be 16 to 63. Now the one thing that is most watched. The M spike is none. (More cheering)

On to SPE. Looks great. Kappa, lambda are normal, free K/L ratio is good 0.84.

GFR, estimated MDRD > 60, again darn kidney, but not too bad.
Beta-2-microglobulin is 1.9 mg/L.

Bone survey has been done though I haven't heard the prognosis from that. Got my own copy and I don't see lesions all over the place. There are a few spots I'm wondering about, but not being a doctor I'll wait to hear what he has to say.

So with m-spike none and other indications being normal, is it possible that first blood test is in error?

[Multibilly]

Re: Neurologist found M band in blood test

by Multibilly on Thu Oct 16, 2014 6:41 pm

Hi SCruze,

Welcome to the forum! Glad you found this place.

What test results or condition led you to be tested for multiple myeloma in the first place?

What initial tests were done that led to a diagnosis of MGUS (or is that just a suspicion on the neurologist's part)?

Are you saying in the title of your thread that you had a serum immunofixation (IFE) which showed that there is monoclonal protein (M-spike, M-band, etc) present? But your serum protein electrophoresis (SPEP) didn't measure any M-spike?

Did you have a 24 hour urine test (UPEP) that showed something abnormal?

Was your kappa/lamda rato from a serum blood freelite assay or a 24 hour urine test? What were the individual kappa and lambda free light chain values from that test?

Note that I find it next to impossible to spot abnormalities on an xray (some lesions do stand out like sore thumbs, but not all of them do ... and it takes a trained radiologist to find them).

Note that this document can give you more insight into which test does what:

http://myeloma.org/pdfs/IMF-U-TestResults-2011_f1web.pdf

[SCruze]

Re: Neurologist found M band in blood test

by SCruze on Thu Oct 16, 2014 7:57 pm

Hello Multibilly,

Thanks for responding. My regular doctor referred me to a neurologist due to a symptom sort of hard for me to explain. Basically, it might be considered a type of restless leg syndrome. But for me it includes my whole body, with all my muscles clenching, arms, legs, abdomen. This has been causing me lots of sleepless nights.

The neurologist ordered a
Immunofixation, IGA, IGG, IGM QT. IMMUNOFIXATION SERUM IMMUNOGLOBULIN.
Test 1 Interpretation <No Reported Value>
IgG kappa monoclonal band present.

No urine test yet. So the values are from the blood test.

Kappa free light chain 8.58 mg/L
Lambda free light chain 10.2 mg/L
K/L free light chain ratio 0.84

I agree with you on the xrays I can't really tell. Still seems like my oncologist would be calling me in sooner than the scheduled appointment on the 28th if it was bad.

I would be happy if this was a misdiagnosis.

[Multibilly]

Re: Neurologist did a blood test that says M band present.

by Multibilly on Thu Oct 16, 2014 8:39 pm

Ah, OK.

Your free light chain values look normal, which is a potentially good sign that nothing might be going on MGUS-wise.

Was one of your IgG, IgA or IgM values out of range?

Was your total protein on your metabolic panel in a normal range?

To have a more complete picture, you would at least need this additional lab test:

Serum Protein Electrophoresis (SPEP): Assesses the amount of abnormal (monoclonal) protein

I wasn't clear if you had one since you said you had an "SPE", but then talked about your kappa and lambda values, which would appear on a different test called the Freelite Chain Assay (or something like that)

If you did have an SPE (this would have lab values like alpha-1 globulin, beta globulin, etc), then it would also mention any measured monoclonal protein (aka paraprotein, M-spike, etc) in a separate notation somewhere on the test ... or say that none was measured.

If the SPEP had a measurable amount of monoclonal protein, then it would likely throw your IgG, IgA or IgM out of whack, and this would in turn raise your total protein count on your metabolic panel. So that is why I was asking about these other values. It may give you a clue before you had an SPEP done.

Hope this helps you and doesn't confuse matters.

[SCruze]

Re: Neurologist found M band in blood test

by SCruze on Thu Oct 16, 2014 9:05 pm

IgG is 193 points low at 571 mg/dL 694-1618 normal range.
The other 2 are in low normal range.
Total protein normal 7.5 g/dL.

I did get the SPEP test as well. It said Monoclonal spike None. Which I liked.

Seems like they all appear negative as to having the spike other than the first test saying IgG kappa monoclonal band present but no reported value.

So could the immunofixation serum test be mistaken?

[Multibilly]

Re: Neurologist found M band in blood test

by Multibilly on Thu Oct 16, 2014 9:26 pm

It really doesn't seem like you have anything to worry about with regard to a monoclonal gammopathy. But I'm not a doc and it really is up to an oncologist to make the call. I'm not sure what others on the forum would say?

Lab tests can sometimes be off (and the IFE is basically a visual inspection looking for some stain patterns). I'm going to guess that your onc might say not to worry about it, or to just get re-tested some time down the road.

Best of luck to you. Let us know what happens.

[SCruze]

Re: Neurologist found M band in blood test

by SCruze on Thu Oct 16, 2014 9:32 pm

That sounds like good news. I'll see what my onc says. Thanks for your assistance.

[SCruze]

Re: Neurologist found M band in blood test

by SCruze on Wed Oct 29, 2014 8:11 am

Update,

Great news. According to my oncologist, all additional test and body survey there is no indication of any m band spike. He believes the original test was possibly in error.

Still, just to be on the safe side, he has scheduled a follow up test in a year.

Thank you Multibilly for your reassuring responses. This has been a real wake up call for me to treasure each moment in my life. My heart and prayers go out to everyone that is affected by this horrific illness.

Bless you all.

[Multibilly]

Re: Neurologist found M band in blood test

by Multibilly on Wed Oct 29, 2014 10:54 am

Thanks for the follow up SCruze. That's great news. I hope you never have a reason to get back on this forum