[Lucas326]

Secondary membranous nephropathy - kappa lambda ratios

by Lucas326 on Mon Oct 05, 2015 9:34 pm

Hi,

I'm currently about 20 weeks pregnant and I was just diagnosed with secondary mem­branous nephropathy after reviewing my renal biopsy with my nephrologist and University of Washington pathologists.

A little bit of background:

They found 4500 mg of protein in my urine at 10 weeks pregnant. Two months later, I receive renal biopsy reports I am diagnosed with secondary membranous nephropathy and was told something underlying is causing my kidney issue.

My biopsy states they found 3+ kappa light chain, 0 lambda light chain. IgG and c3 3+ and trace C1q (am I even speaking English anymore ...) Rare possible tubuloreticular inclusion in endothelial cells, not sure what that means.

My nephrologist was a little brief with me, and I probably wasn't asking the right questions, but basically my plasma cells should be making both kappa and lambda light chains but that's not what they are seeing in the biopsy. Sound okay so far?

I now have an appointment with the hematologist to see why this is and my doctor mentioned I will probably have a bone marrow biopsy done to rule out myeloma? I'm still not even sure if I heard her right, I was by myself trying to take this all in.

Is this a routine next step? Should I be concerned?

I'm a little lost right now. I've had labs taken for lambda kappa ratio and all of that. Still waiting on results. Thank you in advance

[Multibilly]

Re: Secondary membranous nephropathy - kappa lambda ratios

by Multibilly on Mon Oct 05, 2015 10:53 pm

Lucas,

Congrats on being a soon-to-be mother.

If a doctor suspects multiple myeloma, it would be a bit peculiar to jump straight to a bone marrow biopsy without first running some of the typical blood tests for multiple myeloma, such as a serum free light chain assay (this is the test you mentioned that measures your "lambda kappa ratio"), serum protein electrophoresis, and quantified immunoglobulin test.

Is your hematologist at the Fred Hutchinson center? The hematologists there are some of the best in the nation when it comes to sorting out situations like these and you can trust them to be doing the right thing.

For now, I would simply be thankful that your doctor is being careful and is just trying to rule out all possibilities ... and not worry until you get some more test results.

[Lucas326]

Re: Secondary membranous nephropathy - kappa lambda ratios

by Lucas326 on Mon Oct 05, 2015 11:44 pm

She only mentioned the bone marrow biopsy briefly as far as letting me know what future steps would be if something were to come back from the blood tests. I'm still waiting to hear what the results are though.

I guess I'm just kind of confused where myeloma came into play and why it was mentioned. I suppose that is what I'll find out next week at the consultation with the hematologist With pregnancy and now this I feel a little lost!

Thank you for your help.

[antelope1225]

Re: Secondary membranous nephropathy - kappa lambda ratios

by antelope1225 on Tue Oct 06, 2015 9:51 am

Hi Lucas.

I am sure you are feeling overwhelmed and anxious to be pregnant and have strange blood tests, but as Multibilly said, it is very good they are being careful and not ruling out any possibilities.

I hope all goes well and you get some answers soon. If you are not going to the Fred Hutchinson center that Multibilly mentioned, maybe you could go there for a second opinion?

Cathy

[Nancy Shamanna]

Re: Secondary membranous nephropathy - kappa lambda ratios

by Nancy Shamanna on Tue Oct 06, 2015 11:02 am

Hi Lucas,

Sorry to hear that you are having to have these investigations into myeloma done while you are pregnant! At least the tests being done are all blood tests, and not invasive, such as is a bone marrow biopsy (although you have already had a kidney biopsy).

Would you also have an obstetrician who deals with 'high risk' pregnancy ? Just having renal problems would seem to indicate an extra level of care being needed now.

Hope it all goes well, and please let us know how this turns out.