[terryl1]

New Concurrent PET/MRI scan....Bence Jones Kidney Situation

by terryl1 on Sat Sep 17, 2011 9:05 am

Hi, I was dx. 8/11 with multiple myeloma by local hematologist after BMB, 24 hour urine, etc. I believe I have what is called kappa light chain multiple myeloma with Bence Jones present in the urine. Before he referred me to a myeloma expert, he did a skeletal survey (radiographic) which was normal. Next week, the specialist is going to evaluate me using a brand new hybrid PET/MRI scan because his office claims the traditional x ray surveys are inaccurate in showing actual damage. Is this accurate? Also, my original skeletal survey showed possible kidney stones. The local hem. then ordered an ultrasound which showed small, probable non-obstructing kidney stones in each kidney. Kidney function seems ok based on regular CBC. My local hem. believes this condition is unrelated to multiple myeloma. I am not so sure since he admittedly is not a myeloma expert. Is there a chance that these are not kidney stones per se, but rather a build up of Bence Jones proteins which might mimic kidney stones in terms of form and calcification??? I heard kidneys can get clogged up from Bence Jones proteins over time and maybe this is what is happening? Maybe I am surfing the net too much and becoming paranoid? I am going to discuss this with the expert but I would like any possible insight so I can ask him better questions. Thanks. Terry

[Dr. Peter Voorhees]

Re: New Concurrent PET/MRI scan....Bence Jones Kidney Situat

by Dr. Peter Voorhees on Sun Sep 18, 2011 11:39 am

Dear Terry,

Skeletal surveys are not terribly sensitive at detecting more subtle bone damage caused by myeloma. PET, MRI or some hybrid of these technologies is more sensitive at picking up smaller lesions missed by plain x-rays. I think it is a very reasonable thing to do, but be sure it gets covered by your insurance or some other means.

Bence Jones proteins can cause kidney damage but do not form discrete stones or stone-like precipitates. They would also not be picked up on plain x-rays. The stones are likely unrelated. The only scenario I can envision where they might be related is if your uric acid levels in your blood stream are elevated as a result of your myeloma, which has then led to uric acid stones -- this is a stretch, though.

Let me know if you have any other questions. Best of luck to you!

Pete V.