Hi Guys,
Would appreciate any answers. My dad has rheumatoid arthritis and recently began having severe back pain, radiating to the calf. I took him to the ER, at which point they ran x-rays and determined no fractures, no lesions, just old age wear and tear. Creatinine (which was elevated week prior at 3.440) had risen to 5, and he had blood in urine. We were admitted to the hospital at which point a CT scan was done that showed kidney stone, diverticulitis. Started on iv antibiotics and hydration. Creatinine rose and leveled at 5.9.
Kappa Qnt Free Light Chain 12.80 mg/dl
Lambda Qnt Free Light Chains 6.91 mg/dl
Kappa:Lambda Free L/C Ratio 1.85
These were the free light chains levels. Protein in urine was 68 (random, not 24 hr). Calcium in serum was 8.
We are now discharged and waiting for renal follow up. Also will have labs done tomorrow to rerun creatinine levels. Currently I am freaked out by the free light chain levels. Can anyone shed any light.
Also, he is 61 years old, first time having kidney stone and diveriticulitis flare.
Thanks!
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Re: Understanding free light chain results
Hello Tanyab,
Are there results from a urine free light chain test or a blood free light chain test?
If you're not sure, can you let us know what the reference (normal) ranges are for each test result?
Take care.
Are there results from a urine free light chain test or a blood free light chain test?
If you're not sure, can you let us know what the reference (normal) ranges are for each test result?
Take care.
Re: Understanding free light chain results
Tanyab,
The "normal" ranges for sFLC assay are as follows:
Kappa FLC 3.30-19.40 (mg/L)
Lambda FLC 5.71-26.30 (mg/L)
K/L FLC ratio 0.26-1.65
I assume your measuring numbers are the same even though you posted mg/dl
If that is true, he in the normal range for both the kappa and lambda FLCs and is only slightly out of the normal range for the kappa / lambda ratio.
Under the new standards for diagnosing multiple myeloma, sFLC would have to produce an involved / uninvolved free light chain ratio of 100 or greater, and the involved free chain has to be at least 100 mg/L. (A patient's "involved" free light chain - either kappa or lambda - is the one that is above the normal reference range; the uninvolved light chain is the one that typically is in, or below, the normal range)
Based on the foregoing, your father does not have multiple myeloma.
Ron
The "normal" ranges for sFLC assay are as follows:
Kappa FLC 3.30-19.40 (mg/L)
Lambda FLC 5.71-26.30 (mg/L)
K/L FLC ratio 0.26-1.65
I assume your measuring numbers are the same even though you posted mg/dl
If that is true, he in the normal range for both the kappa and lambda FLCs and is only slightly out of the normal range for the kappa / lambda ratio.
Under the new standards for diagnosing multiple myeloma, sFLC would have to produce an involved / uninvolved free light chain ratio of 100 or greater, and the involved free chain has to be at least 100 mg/L. (A patient's "involved" free light chain - either kappa or lambda - is the one that is above the normal reference range; the uninvolved light chain is the one that typically is in, or below, the normal range)
Based on the foregoing, your father does not have multiple myeloma.
Ron
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Ron Harvot - Name: Ron Harvot
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: Feb 2009
- Age at diagnosis: 56
Re: Understanding free light chain results
Hello Tanyab,
I agree with what Ron has written. The only thing I would add is that the "normal" range for the kappa-lambda ratio in patients with renal (kidney) impairment 0.37 - 3.10. Your father's high creatinine level indicates that he has kidney issues, so that's the range that is most likely applicable in his case.
So, like Ron, I don't think there is anything in the free light chain results indicating that your father has multiple myeloma.
Of course, it wouldn't hurt to do a serum immunofixation and protein electrophoresis to see if there are any signs of monoclonal protein in his blood, just to make sure. But, as I said, the free light chain tests aren't really sending up any red flags.
I agree with what Ron has written. The only thing I would add is that the "normal" range for the kappa-lambda ratio in patients with renal (kidney) impairment 0.37 - 3.10. Your father's high creatinine level indicates that he has kidney issues, so that's the range that is most likely applicable in his case.
So, like Ron, I don't think there is anything in the free light chain results indicating that your father has multiple myeloma.
Of course, it wouldn't hurt to do a serum immunofixation and protein electrophoresis to see if there are any signs of monoclonal protein in his blood, just to make sure. But, as I said, the free light chain tests aren't really sending up any red flags.
Re: Understanding free light chain results
I suspect the elevated creatinine was the result of : Acute Kidney stone; Acute Diverticulitis/osis; and infection(s). There is no history of kidney disease,... correct ?
With a tincture of time and antibiotics, creatinine should return to normal. Then, Ron's analysis is prolly good. ( No multiple myeloma).
Kidney stones hurt like hell, and radiate pain in odd patterns.
Good luck.
With a tincture of time and antibiotics, creatinine should return to normal. Then, Ron's analysis is prolly good. ( No multiple myeloma).
Kidney stones hurt like hell, and radiate pain in odd patterns.
Good luck.
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Rneb
6 posts
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