[Tracy J]

Re: SPEP negative for M-protein, immunofixation positive

by Tracy J on Tue Jun 28, 2016 12:15 am

Yes, overall, this is a complicated bunch of stuff to sort through. It's going to take a team of doctors a little bit of time to get it all straightened out.

JimNY, that's an interesting questions. Thanks! It's true that it could be a false positive; in that case there would be NO plasma cell clone producing a bunch of identical proteins. Every test has that possibility, that they just get it wrong.

However, if the monoclonal spike is truly there, I wouldn't call it a false positive, even if it's caused by something other than plasma cell disease. The monoclonal protein is really there, so the test is accurate. It's just that there are so many things that can produce an M-spike, like all manner of inflammatory and autoimmune diseases, as pointed out. I had all that in mind when I suggested "getting to the bottom of it".

This is a tough nut to crack. That's one of the many reasons we are always saying "go to an expert". They know all the little ins and outs, caveats, and tips to using these tests.

You'll figure it out!

[Multibilly]

Re: SPEP negative for M-protein, immunofixation positive

by Multibilly on Tue Jun 28, 2016 9:20 pm

Sadiamitil,

As Tracy mentioned, quite a few New York residents on this forum utilize Memorial Sloan-Kettering. It has a very good reputation in multiple myeloma circles and they have some top notch myeloma specialists on their staff.

Below is a list of various treatment centers in NY with multiple myeloma expertise.

https://myelomabeacon.org/resources/treatment-centers/#New%20York

[sadiamitil]

Re: SPEP negative for M-protein, immunofixation positive

by sadiamitil on Thu Jun 30, 2016 6:37 pm

Hello All ,

Thank you for your help and encouragement You guys are my strength in this tough situation .

A few quick update

1) My husband's internist called me yesterday and he is saying the result of two tyer testing came back and it clearly indicates "no Lyme disease" . He is referring a rheumatologist . We are scheduled this Friday. But his antinuclear antibody IFA is negative.

2) Today my husband (his nickname is Mash) had an appointment with his neurologist, a truly amazing doctor. He cheered Mash and told me to take him to an hematologist / oncologist ASAP. Mash is referred to a physician at Hematology Oncology Associates of Western Suffolk; we will meet with him 7th July.

Thanks and regards.

[sadiamitil]

Re: SPEP negative for M-protein, immunofixation positive

by sadiamitil on Thu Jul 14, 2016 5:23 pm

UPEP results have been emailed to us half an hour ago. Here they are.

Is it active so soon?

UPEP1.jpg (68.58 KiB) Viewed 378 times

UPEP2.jpg (94.98 KiB) Viewed 378 times

[Multibilly]

Re: SPEP negative for M-protein, immunofixation positive

by Multibilly on Thu Jul 14, 2016 6:59 pm

I'm not sure I understand your question "Is it active so soon?". What do you mean?

Note that even though they call monoclonal protein in the urine an "M-spike", this is not measuring the same thing that a SPEP test measures. The SPEP test that was run before measures monoclonal immunoglobulin HEAVY chains. The urine test measures monoclonal immunoglobulin LIGHT chains. But both tests unfortunately call their results an "M-spike".

Given there is an M-spike in the urine, it would be good to run a serum free light chain test, especially since the urine test is notoriously inaccurate at quantifying one's free light chain levels.

I'm not a doc, but it could be that you are dealing with a light chain restricted disorder given the SPEP was negative, but the urine test revealed an M-spike. Again, the serum free light chain assay (when analyzed alongside the SPEP and IFE results) is the best way to help sort out that possibility.