July 31st my mom was rushed to the ER. She was dizzy, throwing up and had diarrhea. She found out that she had a potassium level of 1.9! After 5 hours she was transported to a bigger hospital an hour away where her potassium dropped to 0.9!
We soon learned that she had developed C. diff infection. During her two week stay they mentioned to her that she could have multiple myeloma. They did the 24-hour urine test and blood test. They came back after 4 days and said that, since she had the C. diff. infection, that they shouldn't of tested her for this. That they didn't think she had it.
So ... she gets discharged and goes home, but they order her to come back in 3 weeks take the blood test at a local hospital and results sent to her doctor. The problem ... she doesn't see the doctor until the 19th of this month and the hospital has medical records online. So we now have results that we have no clue what they mean.
My mom suffered from sepsis in 2011 and has Crohn's disease. Here are her results!!
Kappa Free Light Chain 1.4700 mg/l
Lambda Free Light Chain 23,4000 mg/l
Kappa/Lambda ratio 0.0628 mg/l
Forums
Re: Trying to understand mother's test results
Hi,
The normal ranges for the blood (serum) free light chain tests vary a bit from lab to lab, but these are common normal ranges that are often used:
Kappa free light chains: 3.3 - 19.4 mg/L
Lambda free light chains: 5.71 - 26.3 mg/L
Kappa/lambda ratio: 0.26 - 1.65 (patients with no kidney damage)
Kappa/lambda ratio: 0.37 - 3.10 (patients with kidney damage)
So your mother's kappa free light chain (FLC) level is depressed while her lambda free light chain level is very high.
Such readings are a sign that your mother may have some kind of plasma cell disorder, such as multiple myeloma or amyloidosis, but there are a number of other tests that would need to be done to finalize the diagnosis.
For multiple myeloma, for example, the doctors will need to do further blood or urine protein tests (serum or urine electrophoresis, SPEP or UPEP, and immunofixation electrophoresis, IFE), and also tests to measure her kidney function, whether or not she has anemia, her blood calcium level, a bone marrow biopsy, and probably x-rays of her bones to see if she has any bone damage.
All these tests are driven by the diagnostic criteria for multiple myeloma, which you can find explained in the Wikipedia article on multiple myeloma,
http://en.wikipedia.org/wiki/Multiple_myeloma#Diagnostic_criteria
The fact that your mother's potassium levels were off suggest that looking closer at her kidney function should be a key concern. Do her blood tests report her creatinine levels, for example (please provide units and the normal range, if it's included in the tests).
Also, are there test results for her calcium levels and perhaps hemoglobin levels?
If any of her tests suggest that she has experienced kidney damage, please don't wait until the 19th to have your mother evaluated further. See if you can get her an appointment with a hematologist / oncologist sooner than the 19th so her condition can be evaluated by someone with the proper expertise.
The normal ranges for the blood (serum) free light chain tests vary a bit from lab to lab, but these are common normal ranges that are often used:
Kappa free light chains: 3.3 - 19.4 mg/L
Lambda free light chains: 5.71 - 26.3 mg/L
Kappa/lambda ratio: 0.26 - 1.65 (patients with no kidney damage)
Kappa/lambda ratio: 0.37 - 3.10 (patients with kidney damage)
So your mother's kappa free light chain (FLC) level is depressed while her lambda free light chain level is very high.
Such readings are a sign that your mother may have some kind of plasma cell disorder, such as multiple myeloma or amyloidosis, but there are a number of other tests that would need to be done to finalize the diagnosis.
For multiple myeloma, for example, the doctors will need to do further blood or urine protein tests (serum or urine electrophoresis, SPEP or UPEP, and immunofixation electrophoresis, IFE), and also tests to measure her kidney function, whether or not she has anemia, her blood calcium level, a bone marrow biopsy, and probably x-rays of her bones to see if she has any bone damage.
All these tests are driven by the diagnostic criteria for multiple myeloma, which you can find explained in the Wikipedia article on multiple myeloma,
http://en.wikipedia.org/wiki/Multiple_myeloma#Diagnostic_criteria
The fact that your mother's potassium levels were off suggest that looking closer at her kidney function should be a key concern. Do her blood tests report her creatinine levels, for example (please provide units and the normal range, if it's included in the tests).
Also, are there test results for her calcium levels and perhaps hemoglobin levels?
If any of her tests suggest that she has experienced kidney damage, please don't wait until the 19th to have your mother evaluated further. See if you can get her an appointment with a hematologist / oncologist sooner than the 19th so her condition can be evaluated by someone with the proper expertise.
Re: Trying to understand mother's test results
Hi,
Thank you for a response!
My mom noted to me that the Mg/L on the results paper is MG/DL.
Kappa: 1,4700 mg/dl
Lambda: 23,4000 mg/dl
Kappa/Lambda: 0.0628
Calcium: 9.4
Creatinine: 1.31 mg/dl Normal- 0.5099
Hemoglobin level wasn't listed.
Thank you for a response!
My mom noted to me that the Mg/L on the results paper is MG/DL.
Kappa: 1,4700 mg/dl
Lambda: 23,4000 mg/dl
Kappa/Lambda: 0.0628
Calcium: 9.4
Creatinine: 1.31 mg/dl Normal- 0.5099
Hemoglobin level wasn't listed.
-
Maddysmom
Re: Trying to understand mother's test results
We're having trouble interpreting the results you've posted for the kappa and lambda light chain levels. We assume that you're from the U.S., since you're using a "." (not a ",") as the decimal point in several places. So it's not clear to us what you mean by a number like "1,4700".
Our guess at what the free light chain numbers mean -- now that we look at them closer -- is that your mother's kappa level is depressed and her lambda level is high, but still within normal range.
(If others have a different interpretation, feel free to step in.)
Your mother's kappa/lambda ratio, however, is clearly lower than the normal range.
The calcium level of 9.4 seems to be within the normal range of 8.5 to 10.2 mg/dL, but we would feel better if you had provided units for the test result and the normal range for it given by the laboratory.
The creatinine level of 1.31 mg/dl is high for a woman (normal range for women is 0.5 to 1.1 mg/dL according to the references we've consulted). We have heard of myeloma patients who are women who say that their doctors don't like creatinine levels above 1.0.
But we think others here should comment on whether a level of 1.31 should be enough concern for your mother to try to see a doctor sooner than the 19th.
Our guess at what the free light chain numbers mean -- now that we look at them closer -- is that your mother's kappa level is depressed and her lambda level is high, but still within normal range.
(If others have a different interpretation, feel free to step in.)
Your mother's kappa/lambda ratio, however, is clearly lower than the normal range.
The calcium level of 9.4 seems to be within the normal range of 8.5 to 10.2 mg/dL, but we would feel better if you had provided units for the test result and the normal range for it given by the laboratory.
The creatinine level of 1.31 mg/dl is high for a woman (normal range for women is 0.5 to 1.1 mg/dL according to the references we've consulted). We have heard of myeloma patients who are women who say that their doctors don't like creatinine levels above 1.0.
But we think others here should comment on whether a level of 1.31 should be enough concern for your mother to try to see a doctor sooner than the 19th.
Re: Trying to understand mother's test results
Hi,
Thank you so much for all the information - I'm completely grateful. It's hard sitting here trying to understand all these numbers and detecting their meaning. We've never had to deal with anything (besides my mother's sepsis) medical like this, and we have no clue what anything means.
We're from the United States. And I will double check, but that's how the results online looked and that's how my mother wrote it down. But like I said, we have no clue about any of this.
I really do appreciate that you are taking the time to help me with this.
Thank you so much for all the information - I'm completely grateful. It's hard sitting here trying to understand all these numbers and detecting their meaning. We've never had to deal with anything (besides my mother's sepsis) medical like this, and we have no clue what anything means.
We're from the United States. And I will double check, but that's how the results online looked and that's how my mother wrote it down. But like I said, we have no clue about any of this.
I really do appreciate that you are taking the time to help me with this.
-
MaddysMom
Re: Trying to understand mother's test results
My mom has been going in every 3 weeks and having her blood tested.. here are some results.
09/02/2014 AFRICAN AMERICAN G 51mL/min/1.73m2 L >OR=60
09/02/2014 BUN 14mg/dL N 7-25
09/02/2014 BUN/CREAT RATIO 11(calc) N 6-22
09/02/2014 CALCIUM 9.4mg/dL N 8.6-10.4
09/02/2014 CHLORIDE 111mmol/L H 98-110
09/02/2014 CO2 12mmol/L L 19-30
09/02/2014 CREATININE 1.31mg/dL H 0.50-0.99
09/02/2014 GFR ESTIMATED 44mL/min/1.73m2 L >OR= 60
09/02/2014 GLUC,FASTING 70mg/dL N 65-99
09/02/2014 POTASSIUM 3.6mmol/L N 3.5-5.3
09/02/2014 SODIUM 135mmol/L N 135-146
08/25/2014 BUN 11mg/dL N 7-25
08/25/2014 BUN/CREAT RATIO 8(calc) N 6-22
08/25/2014 CALCIUM 8.8mg/dL N 8.6-10.4
08/25/2014 CHLORIDE 108mmol/L N 98-110
08/25/2014 CO2 13mmol/L L 19-30
08/25/2014 CREATININE 1.35mg/dL H 0.50-0.99
08/25/2014 GFR EST AFR-AM 49mL/min/1.73m2 L >OR= 60
08/25/2014 GFR ESTIMATED 42mL/min/1.73m2 L >OR= 60
08/25/2014 GLUC, FASTING 86mg/dL N 65-99
08/25/2014 POTASSIUM 3.5mmol/L N 3.5-5.3
08/25/2014 SODIUM 133mmol/L L 135-146
08/18/2014 AFRICAN AMERICAN G 46mL/min/1.73m2 L >OR= 60
08/18/2014 BUN 15mg/dL N 7-25
08/18/2014 BUN/CREAT RATIO 10(calc) N 6-22
08/18/2014 CALCIUM 9.2mg/dL N 8.6-10.4
08/18/2014 CHLORIDE 107mmol/L N 98-110
08/18/2014 CO2 15mmol/L L 19-30
08/18/2014 CREATININE 1.43mg/dL H 0.50-0.99
08/18/2014 GFR ESTIMATED 39mL/min/1.73m2 L >OR= 60
08/18/2014 GLUC, FASTING 99mg/dL N 65-99
08/18/2014 POTASSIUM 3.5mmol/L N 3.5-5.3
08/18/2014 SODIUM 131mmol/L L 135-146
08/01/2014 #IG 0.01 0.00-0.03
08/01/2014 %BASOPHILS 0.10% 0.00-2.00
08/01/2014 %EOSINOPHILS 1.00% 0.00-8.00
08/01/2014 %IG 0.10 0.00-0.90
08/01/2014 AGE60YEARS
08/01/2014 ALBUMIN 1.6g/dL L 3.4 - 5.6
08/01/2014 ALK PHOS 53U/L 50 - 136
08/01/2014 ALT (SGPT) 68U/L 12 - 78
08/01/2014 AST (SGOT) 237U/L C 15 - 45
08/01/2014 BASO# 0.01 0.00 - 0.10
08/01/2014 BUN 13mg/dL 7 - 18
08/01/2014 CALCIUM 7.4mg/dL L 8.5 - 10.0
08/01/2014 CHLORIDE 94mmol/L L 98 - 107
08/01/2014 CREATININE 1.8mg/dL H 0.6 - 1.0
08/01/2014 DIRECT BILIRUBIN 0.1mg/dL 0.0 - 0.3
08/01/2014 EGFR 31mL/min/1.7 .
08/01/2014 EOSIN# 0.12 0.00 - 0.50
08/01/2014 GFR 31ml/min/1.7
08/01/2014 GFR EST AFR-AM 37mL/min/1.7
08/01/2014 GLUCOSE 108mg/dL 65 - 110
08/01/2014 HCT 25.4% L 35.0 - 48.0.
08/01/2014 HGB 7.6g/dL L 12.0 - 16.0
08/01/2014 INDIRECT BILI 0.1mg/dl 0.1 - 1.0
08/01/2014 LYMPH# 0.72 0.70 - 3.10
08/01/2014 LYMPH% 6.2% L 20.0 - 53.0
08/01/2014 LYMPHS 13% L 20 - 53
08/01/2014 MAGNESIUM 1.1mg/dL L 1.8 - 2.4
08/01/2014 MCH 24.4pg L 25.0 - 35.0.
08/01/2014 MCHC 29.9g/dL L 32.0 - 36.0
08/01/2014 MCV 81.7fl 78.0 - 95.0
08/01/2014 MONO# 0.50 0.20 - 0.90
08/01/2014 MONO % 3% 0 - 10
08/01/2014 NEUT# 10.30 H 1.80 - 7.50
08/01/2014 NEUT% 88.3% H 35.0 - 75.0
08/01/2014 PLATELETS 39610\S\3u L 130 - 400
08/01/2014 POTASSIUM 1.1mmol/L B 3.5 - 5.3.
08/01/2014 RBC 3.1110\S\6uL L 4.20 - 5.40
08/01/2014 RBC MORPH NOT INDICATED
08/01/2014 RDW 14.9% H 11.5 - 14.5
08/01/2014 SEGS 84% H 35 - 75
08/01/2014 SODIUM 137mmol/L 136 - 145
08/01/2014 TOTAL BILI 0.2mg/dL 0.0 - 1.0
08/01/2014 TOTAL CO2 36mmol/L H 21 - 32
08/01/2014 TOTAL PROTEIN 10.4g/dL H 6.4 - 8.2
08/01/2014 WBC 11.710\S\3uL H 4.0 - 11.0
09/02/2014 AFRICAN AMERICAN G 51mL/min/1.73m2 L >OR=60
09/02/2014 BUN 14mg/dL N 7-25
09/02/2014 BUN/CREAT RATIO 11(calc) N 6-22
09/02/2014 CALCIUM 9.4mg/dL N 8.6-10.4
09/02/2014 CHLORIDE 111mmol/L H 98-110
09/02/2014 CO2 12mmol/L L 19-30
09/02/2014 CREATININE 1.31mg/dL H 0.50-0.99
09/02/2014 GFR ESTIMATED 44mL/min/1.73m2 L >OR= 60
09/02/2014 GLUC,FASTING 70mg/dL N 65-99
09/02/2014 POTASSIUM 3.6mmol/L N 3.5-5.3
09/02/2014 SODIUM 135mmol/L N 135-146
08/25/2014 BUN 11mg/dL N 7-25
08/25/2014 BUN/CREAT RATIO 8(calc) N 6-22
08/25/2014 CALCIUM 8.8mg/dL N 8.6-10.4
08/25/2014 CHLORIDE 108mmol/L N 98-110
08/25/2014 CO2 13mmol/L L 19-30
08/25/2014 CREATININE 1.35mg/dL H 0.50-0.99
08/25/2014 GFR EST AFR-AM 49mL/min/1.73m2 L >OR= 60
08/25/2014 GFR ESTIMATED 42mL/min/1.73m2 L >OR= 60
08/25/2014 GLUC, FASTING 86mg/dL N 65-99
08/25/2014 POTASSIUM 3.5mmol/L N 3.5-5.3
08/25/2014 SODIUM 133mmol/L L 135-146
08/18/2014 AFRICAN AMERICAN G 46mL/min/1.73m2 L >OR= 60
08/18/2014 BUN 15mg/dL N 7-25
08/18/2014 BUN/CREAT RATIO 10(calc) N 6-22
08/18/2014 CALCIUM 9.2mg/dL N 8.6-10.4
08/18/2014 CHLORIDE 107mmol/L N 98-110
08/18/2014 CO2 15mmol/L L 19-30
08/18/2014 CREATININE 1.43mg/dL H 0.50-0.99
08/18/2014 GFR ESTIMATED 39mL/min/1.73m2 L >OR= 60
08/18/2014 GLUC, FASTING 99mg/dL N 65-99
08/18/2014 POTASSIUM 3.5mmol/L N 3.5-5.3
08/18/2014 SODIUM 131mmol/L L 135-146
08/01/2014 #IG 0.01 0.00-0.03
08/01/2014 %BASOPHILS 0.10% 0.00-2.00
08/01/2014 %EOSINOPHILS 1.00% 0.00-8.00
08/01/2014 %IG 0.10 0.00-0.90
08/01/2014 AGE60YEARS
08/01/2014 ALBUMIN 1.6g/dL L 3.4 - 5.6
08/01/2014 ALK PHOS 53U/L 50 - 136
08/01/2014 ALT (SGPT) 68U/L 12 - 78
08/01/2014 AST (SGOT) 237U/L C 15 - 45
08/01/2014 BASO# 0.01 0.00 - 0.10
08/01/2014 BUN 13mg/dL 7 - 18
08/01/2014 CALCIUM 7.4mg/dL L 8.5 - 10.0
08/01/2014 CHLORIDE 94mmol/L L 98 - 107
08/01/2014 CREATININE 1.8mg/dL H 0.6 - 1.0
08/01/2014 DIRECT BILIRUBIN 0.1mg/dL 0.0 - 0.3
08/01/2014 EGFR 31mL/min/1.7 .
08/01/2014 EOSIN# 0.12 0.00 - 0.50
08/01/2014 GFR 31ml/min/1.7
08/01/2014 GFR EST AFR-AM 37mL/min/1.7
08/01/2014 GLUCOSE 108mg/dL 65 - 110
08/01/2014 HCT 25.4% L 35.0 - 48.0.
08/01/2014 HGB 7.6g/dL L 12.0 - 16.0
08/01/2014 INDIRECT BILI 0.1mg/dl 0.1 - 1.0
08/01/2014 LYMPH# 0.72 0.70 - 3.10
08/01/2014 LYMPH% 6.2% L 20.0 - 53.0
08/01/2014 LYMPHS 13% L 20 - 53
08/01/2014 MAGNESIUM 1.1mg/dL L 1.8 - 2.4
08/01/2014 MCH 24.4pg L 25.0 - 35.0.
08/01/2014 MCHC 29.9g/dL L 32.0 - 36.0
08/01/2014 MCV 81.7fl 78.0 - 95.0
08/01/2014 MONO# 0.50 0.20 - 0.90
08/01/2014 MONO % 3% 0 - 10
08/01/2014 NEUT# 10.30 H 1.80 - 7.50
08/01/2014 NEUT% 88.3% H 35.0 - 75.0
08/01/2014 PLATELETS 39610\S\3u L 130 - 400
08/01/2014 POTASSIUM 1.1mmol/L B 3.5 - 5.3.
08/01/2014 RBC 3.1110\S\6uL L 4.20 - 5.40
08/01/2014 RBC MORPH NOT INDICATED
08/01/2014 RDW 14.9% H 11.5 - 14.5
08/01/2014 SEGS 84% H 35 - 75
08/01/2014 SODIUM 137mmol/L 136 - 145
08/01/2014 TOTAL BILI 0.2mg/dL 0.0 - 1.0
08/01/2014 TOTAL CO2 36mmol/L H 21 - 32
08/01/2014 TOTAL PROTEIN 10.4g/dL H 6.4 - 8.2
08/01/2014 WBC 11.710\S\3uL H 4.0 - 11.0
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Maddysmom
Re: Trying to understand mother's test results
After looking at her records ... those are indeed decimals! My mom wrote it down wrong! 
KAPPA/LAMBDA LIGHT CHAIN QUANT
Test Name, Code, Test Result, Test Units, Test Date/Time
Kappa Free Light Chain 36916-5 1.4700 mg/dL 09/02/2014 09:20
Lambda Free Light Chain 33944-0 23.4000 mg/dL 09/02/2014 09:20
Kappa/Lambda Ratio 48378-4 0.0628 09/02/2014 09:20
KAPPA/LAMBDA LIGHT CHAIN QUANT
Test Name, Code, Test Result, Test Units, Test Date/Time
Kappa Free Light Chain 36916-5 1.4700 mg/dL 09/02/2014 09:20
Lambda Free Light Chain 33944-0 23.4000 mg/dL 09/02/2014 09:20
Kappa/Lambda Ratio 48378-4 0.0628 09/02/2014 09:20
-
Maddysmom
Re: Trying to understand mother's test results
There's a lot going on with these lab results. But I'm not a doc, so I really can't say how much of this was due to C. diff and her other conditions.
A couple of things that jump out at me are:
1. Back on August 1 (8/1), she was quite anemic.
08/01/2014 HGB 7.6g/dL L 12.0 - 16.0
08/01/2014 RBC 3.1110\S\6uL L 4.20 - 5.40
Is she going to get a new CBC test that would re-measure the hemoglobin (HGB) and red blood cell (RBC) counts?
2. And on September 2 (9/2), her albumin was quite low, her creatinine was high and her GFR was low (all these together can indicate potential kidney problems).
08/01/2014 ALBUMIN 1.6g/dL L 3.4 - 5.6
09/02/2014 CREATININE 1.31mg/dL H 0.50-0.99
08/25/2014 GFR EST AFR-AM 49mL/min/1.73m2 L >OR= 60
3. And her total protein was high on August 1 (8/1).
08/01/2014 TOTAL PROTEIN 10.4g/dL H 6.4 - 8.2
These are all flags for multiple myeloma, but they could be due to other things. And you can't tell if multiple myeloma might be involved from just just these tests in your post. And I'm also mixing in some older test results with the latest ones from September 2.
If there is a suspicion of multiple myeloma, you need to also be asking for other tests such as a Serum Immunofixation (IFE), Serum Protein Electrophoresis Test (SPEP), Quantitative Immuonglobulin tests and a Urine Protein Electrophoresis (UPEP).
I have no idea how much of all this could be due to her current conditions. Again, I'm not a doc, so please do work with one to confirm all this.
A couple of things that jump out at me are:
1. Back on August 1 (8/1), she was quite anemic.
08/01/2014 HGB 7.6g/dL L 12.0 - 16.0
08/01/2014 RBC 3.1110\S\6uL L 4.20 - 5.40
Is she going to get a new CBC test that would re-measure the hemoglobin (HGB) and red blood cell (RBC) counts?
2. And on September 2 (9/2), her albumin was quite low, her creatinine was high and her GFR was low (all these together can indicate potential kidney problems).
08/01/2014 ALBUMIN 1.6g/dL L 3.4 - 5.6
09/02/2014 CREATININE 1.31mg/dL H 0.50-0.99
08/25/2014 GFR EST AFR-AM 49mL/min/1.73m2 L >OR= 60
3. And her total protein was high on August 1 (8/1).
08/01/2014 TOTAL PROTEIN 10.4g/dL H 6.4 - 8.2
These are all flags for multiple myeloma, but they could be due to other things. And you can't tell if multiple myeloma might be involved from just just these tests in your post. And I'm also mixing in some older test results with the latest ones from September 2.
If there is a suspicion of multiple myeloma, you need to also be asking for other tests such as a Serum Immunofixation (IFE), Serum Protein Electrophoresis Test (SPEP), Quantitative Immuonglobulin tests and a Urine Protein Electrophoresis (UPEP).
I have no idea how much of all this could be due to her current conditions. Again, I'm not a doc, so please do work with one to confirm all this.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Trying to understand mother's test results
Maddysmom,
You have done the right thing by coming here to try and figure out what is going on with your Mom. I agree with Multibilly that these values are concerning for myeloma, but your mother will need a full evaluation to know exactly what is happening.
If at all possible, I would try and get your Mom to an oncologist as soon as possible to complete the evaluation.
Again, you have come to the right place for information and support.
My best to you and your Mom,
Jlk
You have done the right thing by coming here to try and figure out what is going on with your Mom. I agree with Multibilly that these values are concerning for myeloma, but your mother will need a full evaluation to know exactly what is happening.
If at all possible, I would try and get your Mom to an oncologist as soon as possible to complete the evaluation.
Again, you have come to the right place for information and support.
My best to you and your Mom,
Jlk
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Dr. Jonathan Kaufman - Name: Jonathan Kaufman, M.D.
Beacon Medical Advisor
Re: Trying to understand mother's test results
Hi Maddysmon,
Please let us know how things work out with your mother and also if you have any further questions.
All of us here wish your mother the best.
Please let us know how things work out with your mother and also if you have any further questions.
All of us here wish your mother the best.
-
Boris Simkovich - Name: Boris Simkovich
Founder
The Myeloma Beacon
13 posts
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