[charlee]

Serum immunofixation results - confusing & scary

by charlee on Fri Nov 20, 2015 10:05 pm

Hello! I just found this forum while searching the Internet for answers to a lab result. I am in my early forties and a Caucasian female. About five months ago I woke up, got out of bed, and was unable to stand up straight. It felt like someone kicked me in my lower right back. The night before I was fine. I had been in the process of selling my home and lived alone, so I was moving furniture from room to room, etc, without asking for help, constantly cleaning to show the home, etc.. The pain didn't go away and started moving across my lower back, into my saddle, tail bone, buttocks.

Then the nerve pain came along, that was scary! The nerve pain went down the right leg first, rear end, behind my knees, heel and toes. Then the other leg and then I had sporadic nerve pain move around through my arms hands and once or twice down my chest.

I went to my doctor, who ordered a lumbar MRI. My L4-L5: disk space narrowing, disk desiccation, and posterior osteophyte complex and a disc bulge. The other findings in the lumbar spine show minimal facet arthrosis. Findings overall: Normal lumbar spine alignment, conus medullans is unremarkable. There is no intradural extramedullary mass and bone marrow signal intensity is normal throughout. Only the lumbar has been looked at.

I thought a bulging disk would satisfy my doctor as far as my symptoms, but he said some people have bulging disks and none of those symptoms. He took the routine blood work and everything was normal. He then sent me to a neurologist that drew blood. The first result of my immunofixation serum states: A poorly defined area of restricted protein mobility is detected and is reactive with IgG and lambda antisera. This finding does not meet strict criteria for a monoclonal immunoglobulin and clinical relevance is not certain.

One month later my immunofixation serum reads: A poorly defined area of restricted protein mobility is detected and is reactive with lambda light chain antisera. This finding does not meet strict diagnostic criteria for monoclonal free light chain and clinical relevance is not certain.

My neurologist said "My recommendation to you is to do nothing. Given your age and your overall health I am not concerned." Well, I am concerned.

Does anyone know what the lab means when it says: This finding does not meet strict diagnostic criteria for monoclonal free light chain and clinical relevance is not certain. Do I or don't I have an M protein and, if so, does that mean I have a disease? What does that lab MEAN?

My doctor has referred me to a hematologist at the cancer center. I have been told do not worry, don't borrow trouble, this is probably nothing. In fact, the hematologist said that lab result means nothing. I guess I'm confused by what the lab actually means and DOES NOT mean.

They drew blood for the test called electrophoresis I believe, and I have to do a 24 hour urine test. He said he doesn't think I have anything to worry about, this test is just for peace of mind. Well, I wont get blood work back until Tuesday and urine will take longer. So for now I am afraid.

I have been having physical therapy for my back for months now and the back pain has diminished greatly, but occurs when I lift something or sit too long. The nerve pain happens rarely now and its not nearly as severe.

I can't find much on the web for this lab result. Do people really get this result and not have a disease?

Any comments would be great.

[Multibilly]

Re: Serum immunofixation results - confusing & scary

by Multibilly on Sat Nov 21, 2015 8:54 am

Charlee,

Welcome to the forum.

If the painful area of your spine that was MRI'd showed no signs of multiple myeloma lytic lesions, that's really good news.

I'm not a doc, but your immunofixation test sounds like it is just on the marginal edge of detecting a monoclonal protein. So, this could in fact just be a testing anomaly and could disappear with time. However, I also think it was prudent of the hematologist to order a serum electrophoresis and a 24 hour UPEP test, just to be on the safe side.

If you go back and look at your metabolic and CBC panels, are your calcium, hemoglobin, total protein, and creatinine levels all in the normal range? These markers may also provide an indication if anything myeloma-related is going on.

The serum electrophoresis test will attempt to measure any monoclonal protein that may be in your blood (the immunofixation test just tries to detect the monoclonal protein's presence, but doesn't actually measure it). The urine test will also do the same thing and will try to detect what are known as free light chains (also called Bence Jones proteins when found in the urine). If those tests come back clean, then you should be home free.

Everyone on this forum hates waiting for lab results and the angst that goes with that process. But with this kind of inconclusive immunofixation, a clean MRI with respect to multiple myeloma, the fact that your back seems to be improving and your young age, I would try not to worry about this and enjoy the weekend.