[Gemm]

Diagnosed with MGUS - what do my lab results mean?

by Gemm on Mon Jul 06, 2015 9:06 am

I am going to post some lab results and see if anyone can understand them. These are from January 2015 and I go back in 2 weeks.

Was told I have MGUS but never really explained what my specific tests mean. I understand you all may not be doctors. Just wanting info if you have it.

Thanks!!

IGG, IGA, IGM PANEL
IgA 114 mg/dL 71-377
IgM 336 High mg/dL 46-208
IgG 711 Low mg/dL 716-1594

COMP METABOLIC PROFILE
Sodium 139 mEq/L 133-145
Potassium 4.7 mEq/L 3.3-5.1
Chloride 105 mEq/L 98-108
CO2 29 mmol/L 22-33
BUN 15 mg/dL 6-23
Creatinine 1.2 mg/dL 0.3-1.2
BUN/Creat Ratio 12.5 CALC
EGFR Non-Afr. American 52 Low ML/MIN 60-200
EGFR African American 62 ML/MIN 60-200
Calcium 9.3 mg/dL 8.4-10.6
Albumin 4.0 g/dL 3.2-5.2
Globulin 2.5 g/dL 1.7-3.7
A/G 1.6 CALC 1.1-2.5
ALK Phos 32 Low U/L 39-147
ALT 13 U/L 0-31
AST 14 U/L 0-31
Total Bili 0.40 mg/dL 0.00-1.00
Glucose 95 mg/dL 70-105
Total Protein 6.5 g/dL 5.9-8.4

SERUM FREE LIGHT CHAINS
Serum kappa 10.32 mg/L 3.30-19.40
Serum lambda 16.27 mg/L 5.71-26.30
Kappa/lambda 0.63 CALC 0.26-1.65

COMPLETE BLOOD COUNT
WBC 8.2 x10^3/UL 4.2-10.0
RBC 4.36 x10^6/UL 3.80-5.40
HGB 13.2 g/dL 12.0-16.0
HCT 42.9 % 37.0-47.0
MCH 30.3 PG 27.0-34.0
RDW 14.2 % 11.5-15.0
PLAT 282 x10^3/UL 140-440
MPV 8.1 fL 7.5-11.5
Lymph# 1.8 x10^3/UL 1.2-3.4
Mono# 0.6 x10^3/UL 0.0-0.6
Lymph% 21.6 % 15.0-40.0
Mono% 7.6 % 0.0-10.0
ANC 5.8 x10^3/UL 1.5-6.5
Gran% 70.8 % 39.0-78.0

IMMUNOFIXATION, SERUM
IF INTERPRETATION: IgG Kappa and a possible
IgM lambda monoclonal protein band(s) present

SERUM PROTEIN ELECTROPHORESIS
Protein, Total 6.5 g/dL 5.9-8.4
Albumin 51.8 % 48.1-59.5
Alpha-1-Globulin 5.1 High % 2.3-4.9
Alpha-2-Globulin 10.8 % 6.9-13.0
Beta Globulin 17.6 % 13.8-19.7
Gamma Globulin 14.7 % 10.1-21.9
A/G Ratio 1.1 CALC
M-spike No monoclonal band observed g/dL

OTHER TESTS

UIBC 442 High ug/dL 110-370
TIBC 516.0 CALC
Iron Sat Percent 14.3 Low % 20.0-49.0
Iron 74 ug/dL 30-160
Folate 12.3 ng/mL 2.6-20.0
Ferritin 27 ng/mL 15-200
B12 615 pg/mL 211-911

[Gemm]

Re: Diagnosed with MGUS - what do my lab results mean?

by Gemm on Sun Jul 12, 2015 4:15 pm

I wish someone would please look at this. I could use some input.

[Carol of Eden]

Re: Diagnosed with MGUS - what do my lab results mean?

by Carol of Eden on Mon Jul 13, 2015 1:13 am

Hi Gemm,

Most of us here (including me) are not doctors, and hesitate to suggest any interpretation of test results as we are not qualified and it might not be correct.

It does look like IgM type MGUS, as the IGM is above normal range. Most of your tests are normal and that is great! In fact, I wish I had your results myself.

Your kidney function seems a little low (related to creatinine and EGRF results), but that may have nothing to do with the MGUS condition. Mine has been in your range, and I suspect I had some damage due to use of ibuprofen over many years, who knows, but most people with our level of kidney function will have kidneys that do just fine for the rest of our lives. It is a good idea to drink plenty of water and avoid NSAID's as they are hard on the kidneys (Advil, etc.).

It is great that your light chains and ratio are within normal limits.

I do not know what to make of the contradictory info in the serum electrophoresis and the immunofixation as to an IgG kappa and IgM lambda bands vs. no monoclonal band found. This is definitely an unusual result, but the number themselves seem low as far as the severity of any condition. If you are seeing a hematologist/oncologist who is not a specialist in myeloma and MGUS conditions, then they may not have seen this type result much either. A myeloma specialist would be the most knowledgeable and there are people on this forum who can help you find one in your area.

I would ask your doctor to explain what this might mean – especially the IgG kappa info when your IgG is near normal (very slightly low) and IgM also being a question mark. It is possible to have more than one clonal plasma cell condition simultaneously (biclonal), which does not confer a worse prognosis. And you can have a condition (nonsecretory) that does not produce the usual light or heavy chain (IgG, IgM, IgA) proliferation and is only detectable thru bone marrow biopsy. You might discuss getting a bone marrow biopsy with your doctor.

Let us know how your next visit goes, and good luck!