[Boobuggey]

New here, looking for help in understanding lab results

by Boobuggey on Sun Mar 02, 2014 4:14 pm

Hi everyone,

I'm brand new here and stumbled upon this forum a few times while attempting to do my own research regarding my recent lab tests. I will do my best to make a very very long story, as short as possible.

Since I was a teenager, I have struggled with various Illnesses, particularly GERD and out of no where ITP. My oncologist at the time carefully watched me for a while and eventually decided it was ITP, low platelets for no actual reason.

Fast forward to modern day, I am 30 years old, I still have the ITP and many other issues including elevated bilirubin (for years now) , fibromyalgia , MVP, and moderately low IgG . The doctor thought it was just "me" but discovered that I wasn't actually making antibodies to things I should be.

And just recently, I had a small amount of protein in my urine , which led my doctor to test me for myeloma. The tests came back negative for monoclonal bands which I know is good. But there was gamma detected in my urine and my free kappa/lambda ratio was elevated at 18.25 (normal 2.04-10.37). (My free kappa light was 0.73 (normal 0.14-2.42) and my free Lambda light was 0.04 (normal 0.02-0.67))

I think I understand why the kappa/lambs ratio is high due to the difference in the two - but they are still within normal range. I just had my gallbladder out rather unexpectedly - so at my appointment that my doctor was going to talk to me about my lab results we were focused on the recent events of the gallbladder and completely forgot about the labs. My kidney function was 60, and due to the protein he had wanted me to see a kidney specialist.

I just am a bit confused about these numbers and hope that I am over thinking what any of this means.

Thank you so much for any insight you can share. I will be calling my doctor in the morning but I'd like to understand this a little better before that if possible.

Ashley

[Multibilly]

Re: New here, looking for help in understanding lab results

by Multibilly on Mon Mar 03, 2014 11:03 am

First off, I'm not a doc, so please follow up with yours. I also have no idea if the other afflictions you have are impacting your current lab results. Only a doc can really comment on this.

Having said that, It sounds like you only had some of the standard lab tests done when one looks for myeloma based on what you are reporting here. If there truly is a suspicion of myeloma, you should be considering all of the laboratory tests outlined below. I'm guessing they just did a 24 hour UPEP, an IFE (which is quite accurate in detecting the presence of monoclonal proteins, but doesn't tell you the amt) and the quantitative immunoglobulin tests from what you say here? Did they do a serum freelite chain and an SPEP test? Note that one's free light chains don't always show up in one's urine (they don't in mine), but they will show up in one's blood serum. Given you have kidney impairment, it seems prudent to be running through all the standard multiple myeloma lab tests and to perhaps consider a bone marrow biopsy, depending on what the lab tests reveal.

https://myeloma.org/ArticlePage.action?tabId=1&menuId=322&articleId=3177&aTab=-1

Also, were your creatinine, BUN and albumin levels normal? Also, not sure which kidney function level you are talking about when you say 60? Do you mean your GFR? A value of 60 ml/min/1.73m2 is on the low side and it is good you are following up with a kidney specialist.

[Boobuggey]

Re: New here, looking for help in understanding lab results

by Boobuggey on Mon Mar 03, 2014 2:02 pm

Hi there,

Thank you for the reply!

I'm still waiting to hear back from dr about all this.

Bun and Alt is low. Has been for a while now. They were never concerned.

Creatine and albumin normal.

He ran the SPEP test, and a Bence Jones test. Everything except for the tests mentioned above came back within normal range. It showed no light chains or monoclonal protein in both serum and urine. I also feel I could be thinking I understand this but could be way off in trying to explain this all. I'm going to run the latest tests over to my immunologist and am hoping she might shed some light for me. I suppose I might be adding a hematologist to my list of doctors now??

Yes, my kidney function test of 60 is the GFR w/ a value of 1.73m2. I know that's still normal but I thought it was kind of low for a 30 y/old. I've been convinced for years that ultimately my issues would prove to be lupus, which I suppose these numbers could indicate that as well but my ANA always comes back negative.

Normally I just go with the flow of things but this time I'm a little bit nervous.

Thanks again for your help.

Ashley

[Multibilly]

Re: New here, looking for help in understanding lab results

by Multibilly on Mon Mar 03, 2014 7:28 pm

Regarding:

"Yes, my kidney function test of 60 is the GFR w/ a value of 1.73m2. I know thats still normal but I thought it was kind of low for a 30 y/old...."

Again, I'm not a doc, but a GFR of 60 for a 30 year old sounds low to me? I believe a normal GFR for a 30 year old without kidney disease is over 100.

http://www.kidney.org/professionals/kls/pdf/12-10-4004_KBB_FAQs_AboutGFR-1.pdf

[Boobuggey]

Re: New here, looking for help in understanding lab results

by Boobuggey on Wed Mar 05, 2014 8:43 am

Wow, I knew it was low but didn't realize for my age how low it was.

Well, my doctor called and said he wants me first going to the kidney doctor, and then maybe to a hematologist depending on what the kidney doctor thinks.

Guess I just have to be patient.

Ashley