[wsudhakar]

M-spike 18 months ago, now gone - investigate further?

by wsudhakar on Tue Jan 14, 2014 8:46 am

Hi there. 18 months ago my liver went nuts (they suspected primary biliary cirrhosis) and as part of the testing they ran a serum protein electrophoresis. It came back with an m-spike. Here are the results:

Albumin 3.2 g/dL (range 3.2-5.6)
Alpha-1 0.3 g/dL (range 0.1-0.4)
Alpha-2 0.8 g/dL (range 0.4-1.2)
Beta 1.7 g/dL (high) (range 0.6-1.3)
Gamma 1.4 g/dL (range 0.5-1.6)
Gamma m=spike 0.3 g/dL
A/G Ratio 0.8

Because my liver failing was the main issue they decided to not worry about this yet. My liver got slowly better (as in the acute attack went away but I still have some chronic issues). Last week I had my yearly regular blood work run and now, after years of Hashimoto's, I probably have Grave's disease (seeing the endocrinologist today). That's just an aside ...

On the blood work, the following showed up:

C-reactive protein 6.9 (range 0-4.9 mg/L)
BUN/Creatinine Ratio 29 (range 9-23)
Alkaline Phosphatase 138 (range 39-117) -- this had gone back to normal but is up again.

So, after playing Google Doctor, a lot seems to be pointing in a particular direction. Can an m spike just show up and then go away on its own? Should I have the protein electrophoresis run again? Help ...

[Multibilly]

Re: M-spike 18 months ago, now gone - investigate further?

by Multibilly on Tue Jan 14, 2014 9:37 am

I would think it prudent to get another SPEP if you had an M-Spike show up before. They are cheap and easy to do. Note that your earlier M-Spike of 0.3 g/dL is quite a low figure.

However, your message is a bit confusing to me. You asked if an M-spike can just go away, yet you don't say if yours did. You also say things are pointing in a particular direction, but you don't say what direction. If you are assuming some sort of moncolonal gammopathy, you really can't make that diagnosis based just on:

C-reactive protein 6.9 (range 0-4.9 mg/L)
BUN/Creatinine Ratio 29 (range 9-23)
Alkaline Phosphatase 138 (range 39-117)--this had gone back to normal but is up again.

If there are open questions or unexplained items in your bloodwork that you have after you see your endocrinologist, I would suggest seeing a hematologist. Hope this helps.

[Anonymous]

Re: M-spike 18 months ago, now gone - investigate further?

by Anonymous on Tue Jan 14, 2014 2:23 pm

Hi there sorry for the confusion. I was just wondering if once an m spike shows up does that mean you will always have an m spike? I have no idea if mine has changed one way or the other as I only had that one test.

[Multibilly]

Re: M-spike 18 months ago, now gone - investigate further?

by Multibilly on Tue Jan 14, 2014 3:15 pm

M-Spikes definitely go up and down. I imagine that given the m-spike was so low, that it could fail to register during a subsequent test due to normal variation. I'm also thinking that given it is so low and you had liver issues going on, you might have seen a polyclonal bump in your immunoglobluin, not a monoclonal spike...these are all just layman guesses from a non-doctor.

If you want to see more on the different types of SPEP interpretations, you can look here:

http://emedicine.medscape.com/article/2087113-overview#aw2aab6b3

Anyway, I would not worry and try to pre-guess all this on the web before seeing your doc. It again seems perfectly reasonable to me to request another SPEP give you saw an M-Spike earlier.