As I've described in an earlier post, my wife has light chain multiple myeloma. She had a stem cell transplant last July and had good results: normal light chains (and ratios) as measured in urine and blood. She's on Revlimid maintenance therapy which seems to have improved things: she now has no evidence of monoclonal proteins in urine or blood as measured by immunofixation.
Recently, a urine test came back labeled "immunofixation". In addition to the "no paraprotein detected" notation, the tests came back with abnormal levels of Alpha 1, Alpha 2, beta & gamma globulin. These were high (should be zero) and the albumin level was low. From what I've read, this indicates abnormal kidney function since Alpha's, betas and gammas should not be passed into the urine. Other serum kidney tests (e.g. GFR) are normal. Blood protein levels are all normal.
My question: what does this mean? Is it normal for a multiple myeloma patient with a very reduced level of the disease? What other tests should be done? What sort of treatment (if any) should be undertaken?
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zephyrus - Name: Lee
- Who do you know with myeloma?: wife
- When were you/they diagnosed?: Feb, 2012
- Age at diagnosis: 64
Re: proteins in urine/blood
Hi Zephyrus, I am light chain only myeloma as well. It sounds like your wife had a UPEP with immunofixation based on a small amount of collected urine. This test can show the presence of monoclonal proteins (Bence Jones) and other proteins but does not quantify them. For that, you need the 24 hour urine test. Also, I think even in a spot urine test, there is a normally a small amount of protein present which is not problematic. Check the reference ranges for the specific test.
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terryl1 - Name: Terry
- Who do you know with myeloma?: self
- When were you/they diagnosed?: August 10, 2011
- Age at diagnosis: 49
Re: proteins in urine/blood
terryl1 wrote:
> Hi Zephyrus, I am light chain only myeloma as well. It sounds like your
> wife had a UPEP with immunofixation based on a small amount of collected
> urine. This test can show the presence of monoclonal proteins (Bence
> Jones) and other proteins but does not quantify them. For that, you need
> the 24 hour urine test. Also, I think even in a spot urine test, there is a
> normally a small amount of protein present which is not problematic. Check
> the reference ranges for the specific test.
You are correct. It was a spot (not 24 hour) test. I was surprised that they gave quantities (in %) for these proteins since I understood the immunofixation to be a (very sensitive) qualitative test only. The measured values range from about 8% to about 21% and the reference ranges are all 0%. Her oncologist later had her do a 24 hour test for which we are awaiting results but I wouldn't expect percentages to be any different.
> Hi Zephyrus, I am light chain only myeloma as well. It sounds like your
> wife had a UPEP with immunofixation based on a small amount of collected
> urine. This test can show the presence of monoclonal proteins (Bence
> Jones) and other proteins but does not quantify them. For that, you need
> the 24 hour urine test. Also, I think even in a spot urine test, there is a
> normally a small amount of protein present which is not problematic. Check
> the reference ranges for the specific test.
You are correct. It was a spot (not 24 hour) test. I was surprised that they gave quantities (in %) for these proteins since I understood the immunofixation to be a (very sensitive) qualitative test only. The measured values range from about 8% to about 21% and the reference ranges are all 0%. Her oncologist later had her do a 24 hour test for which we are awaiting results but I wouldn't expect percentages to be any different.
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zephyrus - Name: Lee
- Who do you know with myeloma?: wife
- When were you/they diagnosed?: Feb, 2012
- Age at diagnosis: 64
Re: proteins in urine/blood
Keep us posted. You may also want to consult with a nephrologist to review everything. Good luck.
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terryl1 - Name: Terry
- Who do you know with myeloma?: self
- When were you/they diagnosed?: August 10, 2011
- Age at diagnosis: 49
Re: proteins in urine/blood
I have an employee who had a check u and was told he could not return to work due to high proteins in the urine. Is there a reason for this? He walks almost all day in and out of building and is nit strenuous and I need to know is this a real problem. Thanks
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Jeff Kiker
Re: proteins in urine/blood
Jeff,
High protein in the urine does not necessarily mean he has multiple myeloma. The information you gave is not detailed enough.
High protein could indicate that the kidney's are not functioning properly but then again may not.
Protein in the urine would not be, in and of itself, a reason he cannot work. There has to be more to it than that. As his employer you should request some type of letter from his Dr explaining why he is not able to work. Many of us with multiple myeloma work full time.
Ron
High protein in the urine does not necessarily mean he has multiple myeloma. The information you gave is not detailed enough.
High protein could indicate that the kidney's are not functioning properly but then again may not.
Protein in the urine would not be, in and of itself, a reason he cannot work. There has to be more to it than that. As his employer you should request some type of letter from his Dr explaining why he is not able to work. Many of us with multiple myeloma work full time.
Ron
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Ron Harvot - Name: Ron Harvot
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: Feb 2009
- Age at diagnosis: 56
6 posts
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