[Drod]

Should I worry

by Drod on Mon Jun 04, 2012 5:16 pm

I am 35 yrs old and I recenlty had some lab work done because I have been extremely tired and constantly cold. No joint or Bone pain. I initially went in asking for a thyroid work up. Everything with my thyroid came back fine, but I noticed on my results that my anion gap was low 5.6. I read that a low anion gap could be a sign of multiple myeloma but I would need further testing. So I went back to the doctor asking for her to run a plasma lgG test but she refused. I was a little mad about this because two years ago today my mother passed away from multiple myeloma. I know that multiple myeloma is not hereditary but I have read artciles that show studies where certain families will have multiple myeloma or certain clusters will have multiple myeloma. I am worried and wanted more testing but the Dr. refused, to pacify me she agreed to redo the same testing in two weeks. I am wondering if I should just contact my mother's oncologist and have her look at my lab work. Am I overreacting?

the other results that were off were:
my Blood pressure was the lowest it has ever been at 99/61
high basophils 0.9
Osmolality Serum was Low 277
High CO2 33
Calcium was low 8.6 (low only by a decimal point)

[Dr. Edward Libby]

Re: Should I worry

by Dr. Edward Libby on Mon Jun 04, 2012 6:42 pm

Hello from Seattle,

Not much to go on here with only a low anion gap. Overall I would not worry. But it is reasonable to have this rechecked in 2 weeks. Myeloma in a 35-year-old is very uncommon, but not impossible. In general, myeloma is not an inherited disease, but there are exceptions.

To put your mind at ease, I think if the anion gap is still abnormal in 2 weeks, then you should have a serum protein electrophoresis (SPEP) and serum free light chain drawn to rule out an underlying plasma cell disorder. If these are normal but your anion gap is still abnormal, then myeloma and myeloma-like disease are not the issue, and your doctor should discuss the case with a kidney expert (nephrologist).

Thank you for this interesting question!

[Drod]

Re: Should I worry

by Drod on Tue Jun 19, 2012 4:38 pm

I had the test redone, anion gap is still low, now at a 6.2, previously 5.6. My calcium has dropped to 8.3 and my AST/SGOT is low. I have not talked with the doctor yet, just picked up copies of my lab tests. I will request a plasma serum test. Hopefully now she will comply with my request. Thank you for your reply and advice.