Hi,
I'm Brazilian and I don't speak English well. But I understand better than I write.
I was diagnosed a month ago MGUS. I have 53 years and have always had excellent health. Normal tests. In December I was operated on the column, a synovial cyst is calcified and stenosis. All benign. Had a pain, sciatica in the right leg, and I was fine. I don't have osteoporosis. The surgery went very well.
In February I had herpes zoster (shingles) that was slow to be diagnosed. I took Ciclovir 800 mg, five times a day.
Last month accused routine exams, MGUS light chain kappa. Do not clean in the urine of 24 hours.
The results:
IgA 218 mg/dL (40-250)
IgG H 1055 mg/dL (650-1600)
IgM H 103 mg/dL (50-200)
I went to a hematologist who said to come back in 6 months for new tests.
I have a lot of questions? Can be a false results? Can be a relation to herpes zoster?
What to do? What can I do to change this? Increase my immunity? What to eat? I avoid carbs and protein?
I apologize for the mistakes ... I'm afraid. I try to think positive but this hard. Thank you.
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Re: False positive MGUS from herpes zoster (shingles)?
Welcome to the forum, Cami.
How was your MGUS diagnosed? Did you have serum protein electophoresis (SPEP) and serum immunofixation electrophoresis (IFE) tests done? The first test would tell you the level of your paraprotein (monoclonal protein, or "M-spike), and the second test would tell you the type of monoclonal protein present (i.e., IgG, IgA, etc.)
Also, what were your free light chain levels?
I realize that you said that you are "light chain kappa", but it would be helpful to know how your doctor got to that diagnosis.
Infections will cause elevations in your immunoglobulins and your free light chains. The elevation in your immunoglobulins can lead to a false positive in the SPEP estimate of your M-spike. So if your M-spike gets measured as, say, 0.1 g/dL, then that could be a false positive.
However, if your M-spike comes up as 0.9 g/dL, I think it's much less likely that you've gotten a false positive.
With your free light chains, it's important that they be measured with a blood test, not just a urine test. And what is particularly important is the ratio of the kappa to the lambda, precisely because infections can elevate both kappa and lambda levels, but not necessarily push the ratio out of the normal range.
There is research that shows that shows that people with MGUS are more likely experience infections. See this article, for example
"Myeloma Precursor Disease MGUS May Increase Risk Of Developing Infections," The Myeloma Beacon, Feb 22, 2012
With MGUS, it is very important to keep in mind that most people with the disease never see it progress to the point where it requires treatment. The risk of progressing to multiple myeloma or another, more serious, plasma cell disorder is only about 1 percent per year. Many people who have MGUS don't even know it and it's never even diagnosed.
Good luck!
How was your MGUS diagnosed? Did you have serum protein electophoresis (SPEP) and serum immunofixation electrophoresis (IFE) tests done? The first test would tell you the level of your paraprotein (monoclonal protein, or "M-spike), and the second test would tell you the type of monoclonal protein present (i.e., IgG, IgA, etc.)
Also, what were your free light chain levels?
I realize that you said that you are "light chain kappa", but it would be helpful to know how your doctor got to that diagnosis.
Infections will cause elevations in your immunoglobulins and your free light chains. The elevation in your immunoglobulins can lead to a false positive in the SPEP estimate of your M-spike. So if your M-spike gets measured as, say, 0.1 g/dL, then that could be a false positive.
However, if your M-spike comes up as 0.9 g/dL, I think it's much less likely that you've gotten a false positive.
With your free light chains, it's important that they be measured with a blood test, not just a urine test. And what is particularly important is the ratio of the kappa to the lambda, precisely because infections can elevate both kappa and lambda levels, but not necessarily push the ratio out of the normal range.
There is research that shows that shows that people with MGUS are more likely experience infections. See this article, for example
"Myeloma Precursor Disease MGUS May Increase Risk Of Developing Infections," The Myeloma Beacon, Feb 22, 2012
With MGUS, it is very important to keep in mind that most people with the disease never see it progress to the point where it requires treatment. The risk of progressing to multiple myeloma or another, more serious, plasma cell disorder is only about 1 percent per year. Many people who have MGUS don't even know it and it's never even diagnosed.
Good luck!
Re: False positive MGUS from herpes zoster (shingles)?
Hi, Terry. Thanks for your answer.
The diagnosis was after a routine examination by a gynecologist. He ordered a CBC and protein electrophoresis sericas:
Serum Protein Electorphoresis Test - May 8, 2015
Albumina 61.3 % 4.23 g/dl 3.57 to 5.42
Alpha1 Globulin 4.2 % 0.29 g/dl 0.18 to 0.40
Alpha2 Globulin 9.8 % 0.68 g/dl 0.45 to 0.97
Beta1 Globulin 6.2 % 0.43 g/dl 0.30 to 0.59
Beta2 Globulin 4.7 % 0.32 g/dl 0.20 to 0.53
Gamma-Globulin 13.8 % 0.95 g/dl 0.71 to 1.54
Ratio Albumin-Globulin 1.58
The lab suggested other tests that the doctor went in May 15, 2015:
Immunofixation revealed the presence of
monoclonal gammopathy IgG kappa light chains type
Light chains kappa 257 mg/dl 170.0 to 370
Light chains lambda 124 mg/dl 90.0 to 210
Ratio kappa-lambda 2.07 1.35 to 2.65
Confirmed the previous examination. I went to a hematologist who passed new take to count the immunoglobulins in 3005, days after they gave:
Protein Electrophoresis
Immunology A IgA 218 mg/dl 40 to 350
Immunology G IgG 1055 mg/d 650 to 1600
Immunology M IgM 103 mg/dl 50 to 300
Immunology, light chains in urine
Kappa chain mg/dl = less than 6.6
Lambda chain mg/dl = less than 3.6
Immunofixation of Proteins – Monoclonal Characterization
Serum Anti-IgA - No qualitative changes
Serum Anti-IgG - Presence of monoclonal band
Serum Anti-IgM - Qualitative changes
Serum Anti-Kappa chains – Presence of monoclonal band
Serum Anti-Lambda chains – Without qualitative changes
Urinalysis-normal
Waaler-Rose, Negative Reaction
Antinuclear antibodies and cytoplasmic antigens-ANA
Substrate: HEp-2 Cells
Positive result
Titration 320-160
Nucleo finely granular
Negative Nucleolos
Mitosis Negative
Negative Ctipoplasma
nADNdsADN BC. IgG negative
All other tests are within the normal range.
I hope I haven't given too much information. Thank you for understanding my doubts. God bless you.
Cami Kings
The diagnosis was after a routine examination by a gynecologist. He ordered a CBC and protein electrophoresis sericas:
Serum Protein Electorphoresis Test - May 8, 2015
Albumina 61.3 % 4.23 g/dl 3.57 to 5.42
Alpha1 Globulin 4.2 % 0.29 g/dl 0.18 to 0.40
Alpha2 Globulin 9.8 % 0.68 g/dl 0.45 to 0.97
Beta1 Globulin 6.2 % 0.43 g/dl 0.30 to 0.59
Beta2 Globulin 4.7 % 0.32 g/dl 0.20 to 0.53
Gamma-Globulin 13.8 % 0.95 g/dl 0.71 to 1.54
Ratio Albumin-Globulin 1.58
The lab suggested other tests that the doctor went in May 15, 2015:
Immunofixation revealed the presence of
monoclonal gammopathy IgG kappa light chains type
Light chains kappa 257 mg/dl 170.0 to 370
Light chains lambda 124 mg/dl 90.0 to 210
Ratio kappa-lambda 2.07 1.35 to 2.65
Confirmed the previous examination. I went to a hematologist who passed new take to count the immunoglobulins in 3005, days after they gave:
Protein Electrophoresis
Immunology A IgA 218 mg/dl 40 to 350
Immunology G IgG 1055 mg/d 650 to 1600
Immunology M IgM 103 mg/dl 50 to 300
Immunology, light chains in urine
Kappa chain mg/dl = less than 6.6
Lambda chain mg/dl = less than 3.6
Immunofixation of Proteins – Monoclonal Characterization
Serum Anti-IgA - No qualitative changes
Serum Anti-IgG - Presence of monoclonal band
Serum Anti-IgM - Qualitative changes
Serum Anti-Kappa chains – Presence of monoclonal band
Serum Anti-Lambda chains – Without qualitative changes
Urinalysis-normal
Waaler-Rose, Negative Reaction
Antinuclear antibodies and cytoplasmic antigens-ANA
Substrate: HEp-2 Cells
Positive result
Titration 320-160
Nucleo finely granular
Negative Nucleolos
Mitosis Negative
Negative Ctipoplasma
nADNdsADN BC. IgG negative
All other tests are within the normal range.
I hope I haven't given too much information. Thank you for understanding my doubts. God bless you.
Cami Kings
Re: False positive MGUS from herpes zoster (shingles)?
Hi, I need help to understand the results of my exams. I live in Lisbon.
Re: False positive MGUS from herpes zoster (shingles)?
Hi Cami,
First off, your immunoglobulin levels all seem to be within normal range. I'm not sure why your lab report says "H" in your first post for your IgG and IgM results since all the results are in range:
IgA 218 mg/dL (40-250)
IgG H 1055 mg/dL (650-1600)
IgM H 103 mg/dL (50-200)
On your Serum Protein Electrophoresis Test below, there should be a comment or entry somewhere on that lab test that talks about your M-spike. This may be also be called an "abnormal protein band", "M-protein", "paraprotein", or "monoclonal protein", etc. If you are looking at online results on a computer, that M-spike value may not be reported, but it should be on the original printout, especially if the immunofixation on May 15th showed the presence of monoclonal proteins. It may also say that it was "unable to quantify" that value, or something like that. If you can find that M-spike value or entry that talks about it, please tell us what it is.
Serum Protein Electrophoresis Test - May 8, 2015
Albumina 61.3 % 4.23 g/dl 3.57 to 5.42
Alpha1 Globulin 4.2 % 0.29 g/dl 0.18 to 0.40
Alpha2 Globulin 9.8 % 0.68 g/dl 0.45 to 0.97
Beta1 Globulin 6.2 % 0.43 g/dl 0.30 to 0.59
Beta2 Globulin 4.7 % 0.32 g/dl 0.20 to 0.53
Gamma-Globulin 13.8 % 0.95 g/dl 0.71 to 1.54
Immunofixation of Proteins – Monoclonal Characterization - May 15, 2015
Serum Anti-IgA - No qualitative changes
Serum Anti-IgG - Presence of monoclonal band
Serum Anti-IgM - Qualitative changes
Serum Anti-Kappa chains – Presence of monoclonal band
Serum Anti-Lambda chains – Without qualitative changes
Remember, we aren't doctors. But given that your IgA / IgG / IgM immunoglobulilns and kappa and lambda values are all within normal range (which is reassuring), and your immunofixation test detected the presence of some monoclonal proteins (this can be somewhat subjective if the monoclonal protein levels are really low), I think your doctor is right to suggest getting re-tested in 6 months and see if the tests still show any potential signs of MGUS.
In the meantime, try not to worry. As Terry mentioned, even if you do end up testing positive for MGUS in the future, the chance of it developing into symptomatic multiple myeloma is only about 1% per year.
First off, your immunoglobulin levels all seem to be within normal range. I'm not sure why your lab report says "H" in your first post for your IgG and IgM results since all the results are in range:
IgA 218 mg/dL (40-250)
IgG H 1055 mg/dL (650-1600)
IgM H 103 mg/dL (50-200)
On your Serum Protein Electrophoresis Test below, there should be a comment or entry somewhere on that lab test that talks about your M-spike. This may be also be called an "abnormal protein band", "M-protein", "paraprotein", or "monoclonal protein", etc. If you are looking at online results on a computer, that M-spike value may not be reported, but it should be on the original printout, especially if the immunofixation on May 15th showed the presence of monoclonal proteins. It may also say that it was "unable to quantify" that value, or something like that. If you can find that M-spike value or entry that talks about it, please tell us what it is.
Serum Protein Electrophoresis Test - May 8, 2015
Albumina 61.3 % 4.23 g/dl 3.57 to 5.42
Alpha1 Globulin 4.2 % 0.29 g/dl 0.18 to 0.40
Alpha2 Globulin 9.8 % 0.68 g/dl 0.45 to 0.97
Beta1 Globulin 6.2 % 0.43 g/dl 0.30 to 0.59
Beta2 Globulin 4.7 % 0.32 g/dl 0.20 to 0.53
Gamma-Globulin 13.8 % 0.95 g/dl 0.71 to 1.54
Immunofixation of Proteins – Monoclonal Characterization - May 15, 2015
Serum Anti-IgA - No qualitative changes
Serum Anti-IgG - Presence of monoclonal band
Serum Anti-IgM - Qualitative changes
Serum Anti-Kappa chains – Presence of monoclonal band
Serum Anti-Lambda chains – Without qualitative changes
Remember, we aren't doctors. But given that your IgA / IgG / IgM immunoglobulilns and kappa and lambda values are all within normal range (which is reassuring), and your immunofixation test detected the presence of some monoclonal proteins (this can be somewhat subjective if the monoclonal protein levels are really low), I think your doctor is right to suggest getting re-tested in 6 months and see if the tests still show any potential signs of MGUS.
In the meantime, try not to worry. As Terry mentioned, even if you do end up testing positive for MGUS in the future, the chance of it developing into symptomatic multiple myeloma is only about 1% per year.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: False positive MGUS from herpes zoster (shingles)?
Hi Multibilly.
Thanks for your reply. To answer your questions:
When I did the first blood test that included electrophoresis of proteins, the lab added the following comment to the result:
At the time of the first survey, I was with a urinary infection. Now I don´t have.
After that, I did the other tests indicated for the laboratory and that gave a monoclonal gammopathy like I wrote the results in the last post.
My doctor said that I have to wait for 3 months to do another exams.
I hope this phase passes and that the next tests the result is better. I'm very anxious. I am taking naltrexone now and doing acupuncture too. Thanks to you and all. God bless you all.
T
Thanks for your reply. To answer your questions:
When I did the first blood test that included electrophoresis of proteins, the lab added the following comment to the result:
Dear colleague:
Electrophoresis of proteins displays a small elevation in the region of the gammaglobulinas that it is clear. Thus I propose case agree with the request of the Imonoglubulinas Sericas Immunofixation, for better clarification of the situation with the quantitative determination of urinary Immunoglobulins, sericas (light and heavy chains) and determination of Bence Jones protein.
At the time of the first survey, I was with a urinary infection. Now I don´t have.
After that, I did the other tests indicated for the laboratory and that gave a monoclonal gammopathy like I wrote the results in the last post.
My doctor said that I have to wait for 3 months to do another exams.
I hope this phase passes and that the next tests the result is better. I'm very anxious. I am taking naltrexone now and doing acupuncture too. Thanks to you and all. God bless you all.
T
6 posts
• Page 1 of 1