Hi there,
Just wondering if you could help me out. My serum free light chains have been up and down however over the last few months the kappa/lambda ratio has become abnormal (deficient). I don't have an M spike so am just wondering whether these results are actually indicative of anything or my GP is going down the wrong track? I am due to have a nuclear bone scan regarding a bone lesion which was seen on an X-ray. I would really appreciate your feedback. My last k/l ratio result was low at 0.17 (normal 0.26-1.65). My kappa count was 2.26mg/L (normal 3.30-19.40). I know they aren't hugely reduced but would like to know if they bear any significance. I have been experiencing fevers, bone pain, weight loss and sweats (just to name a few). Ig levels are all normal aside from IgD which is elevated.
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Re: Querying serum free light chain results
Hi Ozmonto23,
Sorry - I don't have any answers, but do have questions for you... (if you see the post I added just after yours it might make sense).
When you say you 'don't have an M spike ' - does that mean that your IGA,IGM,IGG levels are normal?
When you say 'My serum free light chains have been up and down', how up and down have they been?
Thanks!
Sorry - I don't have any answers, but do have questions for you... (if you see the post I added just after yours it might make sense).
When you say you 'don't have an M spike ' - does that mean that your IGA,IGM,IGG levels are normal?
When you say 'My serum free light chains have been up and down', how up and down have they been?
Thanks!
Re: Querying serum free light chain results
You don't say what your Lambda is, but I assume it's high enough to throw your ratio down. You can have an issue with the Lambda free lights chains, I do.
I think your GP is on the right track, but I wouldn't wait to long to see an oncology hematologist. Frankly with what you already know I question why he hasn't referred you already?
I think your GP is on the right track, but I wouldn't wait to long to see an oncology hematologist. Frankly with what you already know I question why he hasn't referred you already?
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Wayne K - Name: Wayne
- Who do you know with myeloma?: Myself, my sister who passed in '95
- When were you/they diagnosed?: 03/09
- Age at diagnosis: 70
Re: Querying serum free light chain results
I would certainly recommend a referral to a hematolgist/oncologist. IgD level abnormal is always concerning. Bone scans are generally not helpful for bone lesions in myeloma. PET scans can be.
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Dr. Jason Valent - Name: Jason Valent, M.D.
Beacon Medical Advisor
Re: Querying serum free light chain results
Thanks so much for your replies, your feed back is extremely invaluable. My lambda levels have been sporadically elevated for about 5 years, but it is only this year that the kappa levels have become deficient as well as the ratio. The lambda levels were actually normal on my latest test, only kappa was deficient, as was the ratio. I'm under the care of an immunologist (not his field at all - i know) whom believes that the abnormal ratio means nothing without the M protein, however a friend of mine working as a Dr in Germany brought to my attention that there is such a thing as non M-spike myeloma. My IgD levels are only slightly elevated, but have been so for at least 2 years (that's the first time they were ever tested). Im about to be trialled on methotrexate and hydroxychloroquine but am a tad apprehensive due to these results as am not entirely sure they are treating the right thing (assumed autoimmune disease). I believe my SPEP is normal. My uric acid levels are also deficient and my GP was querying whether that is connected. I also have consistent proteinuria.
I will go through my last few test results and list the counts here. It's quite interesting that when my leg pain, sweats etc are at their worst, so are the SFLC levels..... Or is it? hehe
Just to add to this, I actually have a haematologist but haven't seen her in a few years and she is unaware of this, however i don't want to appear neurotic by contacting her if these are just marginally abnormal and don't mean anything - mainly as the immunologist really made me feel that this is the case:O
I will go through my last few test results and list the counts here. It's quite interesting that when my leg pain, sweats etc are at their worst, so are the SFLC levels..... Or is it? hehe
Just to add to this, I actually have a haematologist but haven't seen her in a few years and she is unaware of this, however i don't want to appear neurotic by contacting her if these are just marginally abnormal and don't mean anything - mainly as the immunologist really made me feel that this is the case:O
Re: Querying serum free light chain results
I'm in a similar boat. Can anyone please elaborate on this? Is a low kappa ratio indicative of myeloma type diseases?
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Tompom
Re: Querying serum free light chain results
REGARDING [quote="Tompom"]I'm in a similar boat. Can anyone please elaborate on this? Is a low kappa ratio indicative of myeloma type diseases?[/quote]
You don't say what your various freelite chain values (kappa, lambda, etc) are, nor what the ratio is.
A low kappa/lambda ratio can "possibly" be an indicator of multiple myeloma, but additional tests are required to verify this. As stated earlier, If one of your freelite chain values is elevated, you absolutely don't need to have an M-Spike to have multiple myeloma. You can instead have a "nonsecretory" version of multiple myeloma where only freelite chains will show up in your blood and/or urine and the monoclonal version of a specific heavy chain (this is what an M-Spike measures) does not show up. To definitively verify if you have multiple myeloma, you would need a bone marrow biopsy test.
Note that an M-Spike reading can show up as a "paraprotein" or "M-protein" item on your Serum Protein Electrophoresis test results. It may not actually be called an "M-Spike" on your particular test.
Hope this helps.
You don't say what your various freelite chain values (kappa, lambda, etc) are, nor what the ratio is.
A low kappa/lambda ratio can "possibly" be an indicator of multiple myeloma, but additional tests are required to verify this. As stated earlier, If one of your freelite chain values is elevated, you absolutely don't need to have an M-Spike to have multiple myeloma. You can instead have a "nonsecretory" version of multiple myeloma where only freelite chains will show up in your blood and/or urine and the monoclonal version of a specific heavy chain (this is what an M-Spike measures) does not show up. To definitively verify if you have multiple myeloma, you would need a bone marrow biopsy test.
Note that an M-Spike reading can show up as a "paraprotein" or "M-protein" item on your Serum Protein Electrophoresis test results. It may not actually be called an "M-Spike" on your particular test.
Hope this helps.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Querying serum free light chain results
My mom had the same thing and has just diagnosed with multiple melanoma. Don't wait, go to the oncology dept ASAP.
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conhead
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