Hello,
I am new here. I have hepatitis C and recently had blood work. All my liver numbers are good except for slightly elevated enzymes. All other routine blood tests are in range except for immunoglobulin G (IgG), which is 1730. IgM and IgA are in range. Kappa light chain is 475 and kappa / lambda ratio is 2.83. All research indicates multiple myeloma or kidney disease. No further testing done so far.
Does anyone know of any other reasons for these elevations? I do have enlarged adenoids, which I really know nothing about.
Any input would be most helpful! Hope I'm not dying, I'm only sixty three. I have read that multiple myeloma usually strikes in the sixth decade of life.
Any input would be very much appreciated!
Thank you!
Forums
7 posts
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blaf2 - Name: Barbara
- Who do you know with myeloma?: Nobody
- When were you/they diagnosed?: I haven't been diagnosed
Re: Something came up in my blood work
Hi Barbara,
Welcome to the forum. Although I'm not a doctor, I'll try to help as best I can.
I think before we can say anything about your lab results, we'll have to clear up a few things.
First, you said that your "kappa light chain" is 475. Is this result from a blood (serum) test or from a urine test? If it's from a blood test, it will be labeled something like "serum free light chain test" or "Freelite assay".
Second, did you have either "Serum Protein Electrophoresis" (SPEP) or "Serum Immunofixation" (IFE) tests done and, if so, what sort of results did they report? The most important part of the SPEP would be the line that reports whether an "M-spike", "monoclonal protein", "paraprotein", "abnormal protein band" was found and what that number was.
With a lot of these results, it's also useful to give the units of the test results, and the normal ranges, since different labs often use different units and have different normal ranges.
While you're looking at your test results, you also may want to see if your blood tests report your hemoglobin, creatinine, calcium levels. Those also can be helpful in this sort of situation.
Take care.
Welcome to the forum. Although I'm not a doctor, I'll try to help as best I can.
I think before we can say anything about your lab results, we'll have to clear up a few things.
First, you said that your "kappa light chain" is 475. Is this result from a blood (serum) test or from a urine test? If it's from a blood test, it will be labeled something like "serum free light chain test" or "Freelite assay".
Second, did you have either "Serum Protein Electrophoresis" (SPEP) or "Serum Immunofixation" (IFE) tests done and, if so, what sort of results did they report? The most important part of the SPEP would be the line that reports whether an "M-spike", "monoclonal protein", "paraprotein", "abnormal protein band" was found and what that number was.
With a lot of these results, it's also useful to give the units of the test results, and the normal ranges, since different labs often use different units and have different normal ranges.
While you're looking at your test results, you also may want to see if your blood tests report your hemoglobin, creatinine, calcium levels. Those also can be helpful in this sort of situation.
Take care.
Re: Something came up in my blood work
Calcium, creatinine, and hemoglobin done April 30th. Can't find anything on the SPEP or IFE.
The kappa light chain was from blood work.
The only other thing I see (it's hard to read) is something that ends with "ochondrial Ab.IFA ... in range."
The kappa light chain was from blood work.
The only other thing I see (it's hard to read) is something that ends with "ochondrial Ab.IFA ... in range."
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blaf2 - Name: Barbara
- Who do you know with myeloma?: Nobody
- When were you/they diagnosed?: I haven't been diagnosed
Re: Something came up in my blood work
Hi Barbara,
Here are what are usually considered the normal ranges for the free light chain results:
Kappa: 3.3 - 19.4 mg/L
Lambda: 5.71 - 26.3 mg/L
K/L ratio: 0.26 - 1.65
The kappa and lambda results are usually reported using units that are either mg/L or mg/dL. If your results are reported in mg/dL – which I doubt – then you can convert them to mg/L by multiplying them by 10.
In any case, both your kappa and lambda free light chain levels are elevated. Your kappa level is probably 475 mg/L, although it could be 475 mg/dL, which would be really elevated. Based on your kappa-lambda ratio of 2.83, your lambda level is about 168, which is also elevated.
When both the kappa and lambda levels are elevated, it's often a sign of infection, which is why the ratio is useful. If the two are elevated, but the ratio is in the normal range, then infection is most likely the cause. If the ratio is out of range, as it is in your case, then something else might be going on.
Your IgG is somewhat elevated, although not a lot. The normal range is often given as about 800 to 1600 mg/L. Your reading is 1730 (I'm assuming mg/L). A higher-than-normal IgG level can be a sign of myeloma, but it also can be a sign of infection. For example, in a study done with hepatitis C patients in Brazil, the average IgG level was similar to yours (see the reference below).
You haven't mentioned what your creatinine, calcium, and hemoglobin are, so I'm assuming those are in the normal range, although it still would be useful to know where exactly they are within the normal range.
Given that your kappa-lambda ratio is elevated, as are your kappa and lambda levels, I think it would be a good idea to have your doctor run the SPEP and IFE tests that I mentioned earlier. They would be a big help in determining whether multiple myeloma, or something else, is the cause of your abnormal free light chain levels and ratio.
Good luck!
Reference:
IS Oliviera et al, "Serum levels of immunoglobulin free light chains in patients with chronic hepatitis C presenting cryoglobulinemia", The Brazilian Journal of Infectious Diseases, Nov-Dec 2014 (full text of article)
Here are what are usually considered the normal ranges for the free light chain results:
Kappa: 3.3 - 19.4 mg/L
Lambda: 5.71 - 26.3 mg/L
K/L ratio: 0.26 - 1.65
The kappa and lambda results are usually reported using units that are either mg/L or mg/dL. If your results are reported in mg/dL – which I doubt – then you can convert them to mg/L by multiplying them by 10.
In any case, both your kappa and lambda free light chain levels are elevated. Your kappa level is probably 475 mg/L, although it could be 475 mg/dL, which would be really elevated. Based on your kappa-lambda ratio of 2.83, your lambda level is about 168, which is also elevated.
When both the kappa and lambda levels are elevated, it's often a sign of infection, which is why the ratio is useful. If the two are elevated, but the ratio is in the normal range, then infection is most likely the cause. If the ratio is out of range, as it is in your case, then something else might be going on.
Your IgG is somewhat elevated, although not a lot. The normal range is often given as about 800 to 1600 mg/L. Your reading is 1730 (I'm assuming mg/L). A higher-than-normal IgG level can be a sign of myeloma, but it also can be a sign of infection. For example, in a study done with hepatitis C patients in Brazil, the average IgG level was similar to yours (see the reference below).
You haven't mentioned what your creatinine, calcium, and hemoglobin are, so I'm assuming those are in the normal range, although it still would be useful to know where exactly they are within the normal range.
Given that your kappa-lambda ratio is elevated, as are your kappa and lambda levels, I think it would be a good idea to have your doctor run the SPEP and IFE tests that I mentioned earlier. They would be a big help in determining whether multiple myeloma, or something else, is the cause of your abnormal free light chain levels and ratio.
Good luck!
Reference:
IS Oliviera et al, "Serum levels of immunoglobulin free light chains in patients with chronic hepatitis C presenting cryoglobulinemia", The Brazilian Journal of Infectious Diseases, Nov-Dec 2014 (full text of article)
Re: Something came up in my blood work
Hi Barbara,
Cheryl provided some really good guidance and observations . It would be a bit unusual for your doctor to order a free light chain test and not an IFE or SPEP test. Do you see any tests that include the word "immunofixation" or "electrophoresis" in their title (different labs can can use different variations of the IFE and SPEP names). Also, if you just got these initial lab results, it could be that the results of these other tests may not have come back yet?
In any case, getting the IFE and SPEP tests will be important in helping to sort all this out ... as Cheryl already mentioned.
Best of luck with getting to the bottom of this.
Cheryl provided some really good guidance and observations . It would be a bit unusual for your doctor to order a free light chain test and not an IFE or SPEP test. Do you see any tests that include the word "immunofixation" or "electrophoresis" in their title (different labs can can use different variations of the IFE and SPEP names). Also, if you just got these initial lab results, it could be that the results of these other tests may not have come back yet?
In any case, getting the IFE and SPEP tests will be important in helping to sort all this out ... as Cheryl already mentioned.
Best of luck with getting to the bottom of this.
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Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Something came up in my blood work
My creatinine at the end of April was 0.77. The range is 0.5 - 0.99
Hemoglobin 13.2. The range is 11.7 - 15.5
Calcium Plasma 9.3. The range is 8.6 - 10.4
Kappa/Lambda is 2.83. The range is 1.35 - 2.65
The Kappa Light Chain is 475. The range is 170 - 370 mg/dl
Immunoglobulin G is 1730. The range is 694 - 1618 mg/dL
Hemoglobin 13.2. The range is 11.7 - 15.5
Calcium Plasma 9.3. The range is 8.6 - 10.4
Kappa/Lambda is 2.83. The range is 1.35 - 2.65
The Kappa Light Chain is 475. The range is 170 - 370 mg/dl
Immunoglobulin G is 1730. The range is 694 - 1618 mg/dL
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blaf2 - Name: Barbara
- Who do you know with myeloma?: Nobody
- When were you/they diagnosed?: I haven't been diagnosed
Re: Something came up in my blood work
That's really helpful information, Barbara, and it changes the interpretation of your results a lot. I really should have waited until we got this information before drawing any conclusions. (Lesson learned – I won't do it again!)
It looks like the blood test you had run was not the serum FREE light chain test, but a serum TOTAL light chain test. I say that based on the normal ranges you gave for the kappa, lambda, and kappa-lambda ratio results, which are similar to the ones Quest gives for its TOTAL light chains blood test:
http://www.questdiagnostics.com/testcenter/BUOrderInfo.action?tc=59162N&labCode=SJC
There's a difference between the free light chain blood test and the total light chain blood test. The immunoglobulins in your blood are made up of heavy and light chains. The body produces more light chains than are needed to build finished immunoglobulins, so you have extra light chains floating around in your blood. These are the free light chains.
The test you had run measured your total light chains, which includes the free light chains as well as the light chains that are part of the complete immunoglobulins in your blood. The total light chain test, however, is not particularly useful for diagnosing diseases such as multiple myeloma. One of the doctors who helps out here in the forum, Dr. Valent, discussed exactly this point recently in this forum discussion:
"Free light chains & total light chains - difference?" (started April 7, 2015)
Based on your creatinine, hemoglobin, and calcium levels, I'm guessing that you don't really have anything myeloma-related going on in your body. Your IgG level is above normal, but it's not high for someone with hepatitis (based on the results in the article I mentioned before). The high IgG level is also what is most likely elevating your kappa total light chain level.
You should discuss the results with your doctor. Given the abnormal kappa / light chain level, and also given your age, the doctor may want to run an SPEP and an IFE test just to make sure you do not have a plasma cell disorder. The tests are not expensive, so there's probably no good reason not to do them.
If you have any more questions, please let us know. If you have any additional tests done, please let us know what the results are, regardless of how they turn out.
Good luck!
It looks like the blood test you had run was not the serum FREE light chain test, but a serum TOTAL light chain test. I say that based on the normal ranges you gave for the kappa, lambda, and kappa-lambda ratio results, which are similar to the ones Quest gives for its TOTAL light chains blood test:
http://www.questdiagnostics.com/testcenter/BUOrderInfo.action?tc=59162N&labCode=SJC
There's a difference between the free light chain blood test and the total light chain blood test. The immunoglobulins in your blood are made up of heavy and light chains. The body produces more light chains than are needed to build finished immunoglobulins, so you have extra light chains floating around in your blood. These are the free light chains.
The test you had run measured your total light chains, which includes the free light chains as well as the light chains that are part of the complete immunoglobulins in your blood. The total light chain test, however, is not particularly useful for diagnosing diseases such as multiple myeloma. One of the doctors who helps out here in the forum, Dr. Valent, discussed exactly this point recently in this forum discussion:
"Free light chains & total light chains - difference?" (started April 7, 2015)
Based on your creatinine, hemoglobin, and calcium levels, I'm guessing that you don't really have anything myeloma-related going on in your body. Your IgG level is above normal, but it's not high for someone with hepatitis (based on the results in the article I mentioned before). The high IgG level is also what is most likely elevating your kappa total light chain level.
You should discuss the results with your doctor. Given the abnormal kappa / light chain level, and also given your age, the doctor may want to run an SPEP and an IFE test just to make sure you do not have a plasma cell disorder. The tests are not expensive, so there's probably no good reason not to do them.
If you have any more questions, please let us know. If you have any additional tests done, please let us know what the results are, regardless of how they turn out.
Good luck!
7 posts
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