[dezire1068]

Meaning of immunoglobulin, urine protein & FLC results?

by dezire1068 on Wed Nov 02, 2016 12:36 pm

For six years now I have been having abnormal lab results and no diagnosis. The doctors have been suggesting multiple myeloma, but nothing confirmed.

My latest results (from a new hematologist) make no sense to me as some of the results are in %. Can someone please help me figure this out? My labs are as follows:

IgG, quant 966 mg/dL 650.0-1600.0
IgM, quant 40 mg/dL 50.0-300.0
IgA, quant 453 mg/dL 60.0-350.0

Here's the % values:

Creatinine, random urine 92.7 mg/dL
UPE albumin (Albumin, UPE) 77.2%
UPE alpha 1 globulin (Alpha 1 globulin, UPE) 4.7%
UPE alpha 2 globulin (Alpha 2 globulin, UPE) 4.5%
UPE beta globulin (Beta globulin, UPE) 8.8%
UPE gamma globulin (Gamma globulin, UPE) 4.8%

Kappa light chain, free 33.64 mg/L 3.3-19.4
Lambda light chain, free 13 mg/L 5.71-26.3
Free K/L ratio 2.59 0.26-1.65

Protein, random urine 1650 mg/g creat
Protein, 24 hr urine, mg/dL 153 mg/dL 0-12.0

Thanks in advance.

[Ron Harvot]

Re: Meaning of immunoglobulin, urine protein & FLC results?

by Ron Harvot on Wed Nov 02, 2016 2:37 pm

Dezire,

The tests appear to point to the presence of excess kappa light chain and that, coupled with an above normal kappa-lambda ratio, points to the potential of an excess monoclonal protein. However, the numbers are not that far out of the normal range, so other tests need to be done. You did not mention the serum immunofixation (IF) or a serum protein electrophoresis (SPEP) tests. Those are the most common tests that are run to determine if there is an excess monoclonal protein in the serum by type and the amount. So the tests are incomplete to give a clear picture.

I am less familiar with the urine-based tests to measure kidney function, but from what I could see the creatinine test could be normal depending upon your age.

I would suggest you have the serum immunofixation and SPEP tests run. Also, it is normal for an oncologist to do a bone x-ray scan or PET scan to determine if you have any bone lesions. Finally, a bone marrow biopsy is also done to measure the percentage of any abnormal plasma cells in the bone marrow.

For now all we can do is speculate.