Good afternoon,
I have never been diagnosed with multiple myeloma or any other related disease. However, I have been dealing with some issues with absorption of vitamin B12 for over a year. All tests my internist did came back normal, but my B12 level kept dropping even with weekly shots. She referred me to a hematologist who stated he did not see anything alarming in my labs or history to support one theory or another, so he has done a myriad of blood tests.
Some results have started to come back and I am having trouble understanding what they may mean. Any help would be greatly appreciated. I am currently doing a 24-hour urine test, so I assume those results will also help clarify some things.
B12 175 - Low (Range 211-900)
Folate 10.0
IgG 932
IgA 204
IgM 110
Serum Kappa 7.73 mg/L
Serum Lambda 2.11 mg/L - Low (Range 5.71-26.29)
Kappa/lambda, free 3.66 calc - High (Range 0.26-1.65)
M-Spike No monoclonal band observed
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Re: Low lambda FLC level, high kappa / lambda ratio?
Hi Sarasotagirl,
Welcome to the forum.
First off, I'm not a doc, so please verify all this with a doctor. I also don't want to give you the impression that you may have multiple myeloma, but there are a couple of things that you should keep in mind as you rule out the possibility of a plasma cell disorder such as multiple myeloma.
In some cases, multiple myeloma can be associated with a B12 deficiency. See:
LT Vlasveld, "Low cobalamin (vitamin B12) levels in multiple myeloma: a retrospective study", The Netherlands Journal of Medicine, Aug 2003 (abstract, full text of article [PDF])
Also, a normal kappa and low lambda free light chain level, coupled with a high kappa/lambda ratio, can signal the presence of a monoclonal gammopathy with bone marrow suppression (lowered blood platelet levels and/or lowered red and/or white blood cell counts). There are also forms of multiple myeloma where no M-spike is present in one's blood and only the free light chains are affected.
A 24-hour urine test may or may not provide some additional clues, but it may not be definitive in helping to get to the bottom of all this.
Given your presentation, I might suggest seeking out a hematologist that specializes in multiple myeloma and who might be able to better direct and interpret your tests. If you let us know what city you are in, folks can make some recommendations on where to find these specialists.
Again, I am just mentioning all this to help rule out what would be a pretty remote corner case for a diagnosis of a plasma cell disorder.
Welcome to the forum.
First off, I'm not a doc, so please verify all this with a doctor. I also don't want to give you the impression that you may have multiple myeloma, but there are a couple of things that you should keep in mind as you rule out the possibility of a plasma cell disorder such as multiple myeloma.
In some cases, multiple myeloma can be associated with a B12 deficiency. See:
LT Vlasveld, "Low cobalamin (vitamin B12) levels in multiple myeloma: a retrospective study", The Netherlands Journal of Medicine, Aug 2003 (abstract, full text of article [PDF])
Also, a normal kappa and low lambda free light chain level, coupled with a high kappa/lambda ratio, can signal the presence of a monoclonal gammopathy with bone marrow suppression (lowered blood platelet levels and/or lowered red and/or white blood cell counts). There are also forms of multiple myeloma where no M-spike is present in one's blood and only the free light chains are affected.
A 24-hour urine test may or may not provide some additional clues, but it may not be definitive in helping to get to the bottom of all this.
Given your presentation, I might suggest seeking out a hematologist that specializes in multiple myeloma and who might be able to better direct and interpret your tests. If you let us know what city you are in, folks can make some recommendations on where to find these specialists.
Again, I am just mentioning all this to help rule out what would be a pretty remote corner case for a diagnosis of a plasma cell disorder.
-
Multibilly - Name: Multibilly
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: Smoldering, Nov, 2012
Re: Low lambda FLC level, high kappa / lambda ratio?
Thank you so much for your reply! I did also receive some more tests back which were abnormal. At this point I'm not sure whether or not to be more worried or more relaxed! I am currently seeing a hematologist in Sarasota at Florida Cancer Specialists. Hopefully, he will be able to give me clear answers soon.
Not sure if any of these test results would help but here is what else has been found:
Albumin 46.9 Low % 48.1-59.5
Beta Globulin 20.2 High % 13.8-19.7
Methylmalonic Acid 80 Low nmol/L 87-318
Retic 108240 High cells/uL 20000-80000
EBV Nuclear AG AG (EBNA) AB (IGG) 1.21 High
Not sure if any of these test results would help but here is what else has been found:
Albumin 46.9 Low % 48.1-59.5
Beta Globulin 20.2 High % 13.8-19.7
Methylmalonic Acid 80 Low nmol/L 87-318
Retic 108240 High cells/uL 20000-80000
EBV Nuclear AG AG (EBNA) AB (IGG) 1.21 High
3 posts
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