[JenC]

Possible MGUS / myeloma: what other tests should I have?

by JenC on Wed Oct 05, 2016 3:45 pm

Hello,

I have been referred by my rheumatologist to an oncologist due to some elevated labs. I had seen the rheumatologist after seeing my GP and a neurologist for some one-sided neurologic symptoms and body-wide slight muscle fatigue. I have an appointment but am just wondering what other labs might be suggested so I can go in like I know what I'm talking about

Calcium was 9.3
Creatinine was 0.92 (0.55-1.30 mg/dL)

Component Value Ref Range & Units Status
Total Protein,Serum 7.5 6.1-8.3 g/dL Final
Albumin, Serum 4.52 3.50-4.80 g/dL Final
Alpha-1 Globulin 0.16 0.10-0.30 g/dL Final
Alpha-2 Globulin 0.77 0.60-1.00 g/dL Final
Beta Globulin 0.72 0.70-1.20 g/dL Final
Gamma Globulin 1.34 0.60-1.60 g/dL Final
A/G Ratio 1.52 Final

Protein Elect Interpretation: Final

No apparent monoclonal protein on serum electrophoresis.
Normal SPEP pattern and quantitation.

Immunofixation: Final

No monoclonal protein detected by immunofixation.
Kappa band has polyclonal expansion compared with lambda band.
Serum free light chain kappa minimally elevated, likely a polyclonal increase similar to that seen in the IFE. May be related to a systemic inflammatory disease and/or renal insufficiency.

Kappa Free Light Chain 2.099 H 0.330-1.940 mg/dL Final
Lambda Free Light Chain 1.124 0.571-2.630 mg/dL Final
Kappa/Lambda Flc Ratio 1.87 H 0.26-1.65 Final

Note: If renal impairment is present, use a reference range of 0.37 - 3.10 for kappa / lambda free light chain ratio.

[Multibilly]

Re: Possible MGUS / myeloma: what other tests should I have?

by Multibilly on Wed Oct 05, 2016 6:01 pm

Hi JenC,

Have any of your doctors actually suggested the possibility of MGUS or multiple myeloma? You've had a serum immunofixation, serum protein electrophoresis, and serum free light chain test, and your calcium and creatinine levels look fine. I think your immunofixation results summarize things nicely: "serum free light chain kappa minimally elevated, likely a polyclonal increase similar to that seen in the IFE. May be related to a systemic inflammatory disease and/or renal insufficiency". I'm not a doc, but based on your immunofixation results, you aren't likely looking at a monoclonal plasma cell disorder such as MGUS that would require any more testing for such a condition.

A 24 hour urine test is really the only other test that I can think of that MIGHT make sense if MGUS was suspected. But I bet your oncologist won't suggest it given your other test results.