Hi all,
My husband is in his mid 30s and his family doctor noticed that he had proteinuria on some routine labs. So she ordered a random (first morning urine) urine protein electrophoresis (UPEP). The results showed that he had high kappa free light chains and a high kappa/lambda ratio (see below):
Component Standard Range Your Value
Kappa Chains Urine 0.39 - 15.10 mg/L 30.60
Lambda Chains Urine 0.81 - 10.10 mg/L 4.34
Kappa/Lambda Ratio,U 0.46 - 4.00 ratio 7.05
Albumin Electrophoresis 2.1
Alpha 1, Urine 4.2
Alpha 2, Urine 1.8
Beta, Urine 1.5
Gamma Globulin, Urine 1.3
M Spike Urine 0.0
Total Protein, Ur 11
Interpretation (UPE)
Normal urine protein pattern. No monoclonal or Bence Jones proteins detected.
So based on this abnormal result, she ordered a serum protein electrophoresis (SPEP). All results were normal (normal light chain amounts, ratio, no M spike).
His doctor said that this is beyond her realm of expertise and is referring him to a nephrologist. He cannot get in to see anyone for about a month and is completely losing it in the meantime, so I am trying to help him find some answers and calm his nerves.
My question is, is it possible to have a high kappa light chains in the urine and still be healthy? We are confused by the interpretation saying "no monoclonal proteins detected." This is good, right?
Thanks in advance. I have been reading a lot on this board and the info here has been priceless in trying to understand a confusing topic!
Forums
3 posts
• Page 1 of 1
Re: New here & confused - high kappa light chains in urine
Hi Kendall,
When you say "random" urine test, I take it that this means that the urine was just collected on the spot and not collected for 24 hours, right? These kinds of random urine tests are not very reliable for measuring free light chains, so part of the problem may be the urine test itself.
Yes, it's very good news that the SPEP showed no M-spike (no monoclonal proteins were measured in the blood). It sounds like they also ran a serum free light chain test . The fact that both of these tests came back normal means that is very unlikely that you are looking at multiple myeloma.
Many things can cause an increase of normal (polyclonal) free light chains , including various inflammatory conditions and autoimmune diseases. And, again, a random urine test is not the greatest test for measuring free light chains in the first place.
The nephrologist will probably look at all the lab results and take it from there, understanding that there could be lots of causes for elevated polyclonal free light chains. He / she might simply say to take it easy and just get re-tested in a few weeks or might ask that you do a 24 hour urine test.
I'm not a doc and one needs to really verify all this. But I would take heart that this is very likely not multiple myeloma and try not to worry too much.
When you say "random" urine test, I take it that this means that the urine was just collected on the spot and not collected for 24 hours, right? These kinds of random urine tests are not very reliable for measuring free light chains, so part of the problem may be the urine test itself.
Yes, it's very good news that the SPEP showed no M-spike (no monoclonal proteins were measured in the blood). It sounds like they also ran a serum free light chain test . The fact that both of these tests came back normal means that is very unlikely that you are looking at multiple myeloma.
Many things can cause an increase of normal (polyclonal) free light chains , including various inflammatory conditions and autoimmune diseases. And, again, a random urine test is not the greatest test for measuring free light chains in the first place.
The nephrologist will probably look at all the lab results and take it from there, understanding that there could be lots of causes for elevated polyclonal free light chains. He / she might simply say to take it easy and just get re-tested in a few weeks or might ask that you do a 24 hour urine test.
I'm not a doc and one needs to really verify all this. But I would take heart that this is very likely not multiple myeloma and try not to worry too much.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: New here & confused - high kappa light chains in urine
There are a number of conditions/ diseases that trace from "Spilling Proteins in your urine". Apparently your loved one is doing that. One initially thinks of kidney disease, Diabetes, etc.
Hubby should followup with the nephrologist.
Most Myeloma diagnosis(es) are made using a Serum (Blood) analysis and further corraborated with radiology demonstrating skeletal damage, kidney damage, excess calcium (Serum), Anemia, etc.
An M spike is the result of chemical deposits ( faint lines) on a medium ( cellulose) that has had serum passed over it, while it is being electrically charged, such that the serum components separate, and some components form a distinct collection (quantifiable) , usually in a distinct pattern ( IgG , IgM, IgA, etc) in a predictive area of the medium.
You do not typically see an M spike from urine. You measure total Proteins in the urine.
The limitation with using a 24 Hr urine "catch" is that not all proteins are sized the same, so a negative Protein "Catch", just shows that likely the Proteins are too large to pass thru the nephrils, and pass into the urine.
I had a negative 24 hr catch Urine Test, negative Bone marrow biopsy, etc., yet my Serum had a definite M Spike and was quanitfiable, distinct, and predictive. (10.3 % of total)
I'm glad the SPEP for your hubby was clear.
Follow up with the nephrologists.
Good luck.
Hubby should followup with the nephrologist.
Most Myeloma diagnosis(es) are made using a Serum (Blood) analysis and further corraborated with radiology demonstrating skeletal damage, kidney damage, excess calcium (Serum), Anemia, etc.
An M spike is the result of chemical deposits ( faint lines) on a medium ( cellulose) that has had serum passed over it, while it is being electrically charged, such that the serum components separate, and some components form a distinct collection (quantifiable) , usually in a distinct pattern ( IgG , IgM, IgA, etc) in a predictive area of the medium.
You do not typically see an M spike from urine. You measure total Proteins in the urine.
The limitation with using a 24 Hr urine "catch" is that not all proteins are sized the same, so a negative Protein "Catch", just shows that likely the Proteins are too large to pass thru the nephrils, and pass into the urine.
I had a negative 24 hr catch Urine Test, negative Bone marrow biopsy, etc., yet my Serum had a definite M Spike and was quanitfiable, distinct, and predictive. (10.3 % of total)
I'm glad the SPEP for your hubby was clear.
Follow up with the nephrologists.
Good luck.
-
Rneb
3 posts
• Page 1 of 1