Hi , I was diagnosed with IgG lambda MGUS in Nov 2013 . This was due to an incidental finding when I was being investigated for facial sensation issues 2 years post Bell's palsy. I ended up having a brain MRI, which was abnormal, and this resulted in many more tests. At the end of the day no cause was found for the MRI changes and my facial problems are being successfully treated with botox .
From what I can gather from my doctor and this forum, all my levels with regard to my MGUS are not worrying and the likely hood of getting myeloma is very low, but I would still like to understand the change in my blood test results. I have searched the literature and can not really find an answer.
Quantification of the monoclonal band is 10.4 g/l stable
Calcium 2.1 mmol/l latest 2.5 mmol/l range (2.1-2.5)
Haemoglobin , platelets, WBC normal
Normal renal function
IgG 17.8 g/l range (7-16)
IgA 1.0 g/l range (0.8-4.0)
IgM 0.3 g/l range (0.4 -2.5)
In November 2013:
FLC kappa 4.4 mg/l range (3.3-19.4)
FLC lambda 30.6 mg/l range ( 5.7 - 26.3)
Ratio 0.14 range (0.26 - 1.65)
In March 2014:
FLC kappa 0.8mg/l
FLC lambda 27.2
Ratio 0.03
Comment Kappa FLCs assayed on neat serum compared with the standard 1:10 dilution used on the previous sample. Results analysed using a binding site SPA plus
My doctor has emailed the specialist and the plan is to continue to monitor and I will see the doctor in November if nothing else changes. I am happy with this but would like to understand the change in result.
I am very well , I participate in endurance sport and completed an ironman triathlon a month before my last blood tests . Thanks this is a great resource for people
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Re: MGUS, drop in free light chain ratio
I don't think there is really an explanation to be had for this change. Fluctuations in one's markers are part and parcel to both MGUS and smoldering myeloma.
I would simply suggest charting your key markers over time to see if you notice any major long-term trends or a very dramatic and rapid deterioration of your markers. You will very likely find that they will bounce around quite a bit, so don't worry about a marker going a bit south on one of your visits.
I would simply suggest charting your key markers over time to see if you notice any major long-term trends or a very dramatic and rapid deterioration of your markers. You will very likely find that they will bounce around quite a bit, so don't worry about a marker going a bit south on one of your visits.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: MGUS, drop in free light chain ratio
Dear Blue Eyes,
I would agree with Multibilly. I am guessing that the monoclonal protein is an IgG lambda - is that correct? I am making that assumption based on your IgG and serum free lambda light chain levels being slightly elevated.
If my assumption is correct, I do not think you have anything to worry about. The serum free lambda light chain level is actually being read as lower now. The serum free kappa light chain level was also lower, disproportionately so, which has had an impact on the ratio.
Again, as Multibilly pointed out, the free light chain test is useful, but fluctuations from test to test are common. The fact that the serum free lambda light chain level is not increasing is encouraging. Following it over time with more data points will give you a clearer picture of how things are playing out over time.
As an aside, in what way was your MRI abnormal?
I hope this helps.
Thanks and take care!
Pete V.
I would agree with Multibilly. I am guessing that the monoclonal protein is an IgG lambda - is that correct? I am making that assumption based on your IgG and serum free lambda light chain levels being slightly elevated.
If my assumption is correct, I do not think you have anything to worry about. The serum free lambda light chain level is actually being read as lower now. The serum free kappa light chain level was also lower, disproportionately so, which has had an impact on the ratio.
Again, as Multibilly pointed out, the free light chain test is useful, but fluctuations from test to test are common. The fact that the serum free lambda light chain level is not increasing is encouraging. Following it over time with more data points will give you a clearer picture of how things are playing out over time.
As an aside, in what way was your MRI abnormal?
I hope this helps.
Thanks and take care!
Pete V.
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Dr. Peter Voorhees - Name: Peter Voorhees, M.D.
Beacon Medical Advisor
Re: MGUS, drop in free light chain ratio
Thanks Peter and Multibilly.
Yes, it's IgG lambda, and yes, due to the low level of lambda, I was really more curious than worried, and I am a clinical charge nurse in intensive care so I like to try to understand the science
MRI result multiple foci of high signal in deep white matter not typical of my age 48. Small vessel ischaemic disease possible and not typical of demylinating syndrome but possible vasculitis should be considered (from conclusion of report).
Saw neurologist, had LP and bloods looking for oligoclonal bands (that's where the monoclonal band was picked up) had one in CSF and blood. Had normal trans esophageal echo, normal 24-hr BP monitor. All the vasculitis screening bloods were normal.
I am well and not dwelling on my scan result. I work hard and participate in my sport and consider myself fit and well.
Thanks again for the replies and providing a great resource for people .
Yes, it's IgG lambda, and yes, due to the low level of lambda, I was really more curious than worried, and I am a clinical charge nurse in intensive care so I like to try to understand the science
MRI result multiple foci of high signal in deep white matter not typical of my age 48. Small vessel ischaemic disease possible and not typical of demylinating syndrome but possible vasculitis should be considered (from conclusion of report).
Saw neurologist, had LP and bloods looking for oligoclonal bands (that's where the monoclonal band was picked up) had one in CSF and blood. Had normal trans esophageal echo, normal 24-hr BP monitor. All the vasculitis screening bloods were normal.
I am well and not dwelling on my scan result. I work hard and participate in my sport and consider myself fit and well.
Thanks again for the replies and providing a great resource for people .
4 posts
• Page 1 of 1