[Sara]

Which is more reliable for diagnosis - SPEP or UPEP?

by Sara on Sun Jun 01, 2014 9:14 am

I'm being tested for myeloma presently for chronic intermittent and localized bone pain in ribs, back, spine, shoulder blades, hips and now ankle bone, and so far (as mentioned in my other thread on the topic), my SPEP and Immunofixation came back negative.

My rheumatologist did other tests looking for RA and autoimmune - all negative, and nuclear bone scan negative for osteo issues of any kind (though increased tracer uptake in both my big toes "hot spots which he wasn't concerned about).

He's referring me to a hem/onc for the remainder of tests and imaging.

I just wanted to ask if a person can have MGUS or smoldering myeloma (as opposed to other types of multiple myeloma) and have a normal SPEP and yet have it turn up in the UPEP.

Please pardon my ignorance on the subject - there are so many different types of myelomas and related conditions!

This is my original thread:
https://myelomabeacon.org/forum/wondering-if-i-have-mgus-or-smoldering-myeloma-t3205.html

[Dr. Jason Valent]

Re: Which is more reliable for diagnosis - SPEP or UPEP?

by Dr. Jason Valent on Mon Jun 02, 2014 5:34 pm

Yes, it is possible to have a monoclonal protein detected only on urine testing and not serum. This is less common, though, with the use of serum free light chain testing.

[Sara]

Re: Which is more reliable for diagnosis - SPEP or UPEP?

by Sara on Tue Jun 03, 2014 7:19 am

I know my doctor did a SPEP for me and Immunofixation (both negative), but now being referred to a hematologist because I wasn't comfortable that there was no explanation for these pains I've been having, from either routine blood work or bone scan (also negative), so I want to make sure it's nothing serious - but I have a bit of a wait.

So one could specifically have MGUS that shows up only in urine testing long before myeloma is (if) ever diagnosed? And would this mean if it lead to myeloma it would be the light chain kind?

[Dr. Jason Valent]

Re: Which is more reliable for diagnosis - SPEP or UPEP?

by Dr. Jason Valent on Wed Jun 04, 2014 1:26 pm

Yes, MGUS may show up on urine testing before the myeloma, but it does not necessarily mean it will be light chain kind. Hopefully the hematologist you see will check the light chains now as well.