[lisaobradovich]

Unsure of lab results

by lisaobradovich on Sat Mar 01, 2014 8:55 am

I had some lab results I'm unsure about. I was reading about abnormal readings of these tests, and I'm not sure if they are indicative of myeloma. I had a past HX of high Angiotensin II as well. I know my IgG has been low since 2012. In 2012 my IgG was 669. I've had two test in the last month for IgG (one was 622 and the other was 639). Serum Lambda was low, KAPPA/Lambda Free was high.

Tests were as follows:

Result Value (Previous) Units Range Lab
IGG, IGA, IGM PANEL
IGA 142 mg/dL 71-377 LabPak-FMO-jfh
IGM 121 mg/dL 46-208 LabPak-FMO-jfh
IGG 639 Low mg/dL 716-1594 LabPak-FMO-jfh

KAPPA LIGHT CHAINS
SERUM KAPPA 5.24 mg/L 3.30-19.40 LabPak-FMO-jfh

LAMBDA LIGHT CHAINS
SERUM LAMBDA 2.38 Low mg/L 5.71-26.30 LabPak-FMO-jfh

COMP METABOLIC PROFILE
SODIUM 141 mEq/L 133-145 LabPak-FMO-jfh
POTASSIUM 4.4 mEq/L 3.3-5.1 LabPak-FMO-jfh
CHLORIDE 105 mEq/L 98-108 LabPak-FMO-jfh
CO2 23 mmol/L 22-33 LabPak-FMO-jfh
BUN 18 mg/dL 6-23 LabPak-FMO-jfh
CREAT 0.7 mg/dL 0.3-1.2 LabPak-FMO-jfh
BUN/CREAT RATIO 25.7 CALC LabPak-FMO-jfh
EGFR NON-AFR. AMERICAN 96 ML/MIN 60-200 LabPak-jfh
EGFR AFRICAN AMERICAN 116 ML/MIN 60-200 LabPak-jfh
CALCIUM 9.8 mg/dL 8.4-10.6 LabPak-FMO-jfh
ALBUMIN 4.6 g/dL 3.2-5.2 LabPak-FMO-jfh
GLOBULIN 2.2 g/dL LabPak-FMO-jfh
A/G 2.1 CALC 1.1-2.5 LabPak-FMO-jfh
ALK PHOS 40 U/L 39-147 LabPak-FMO-jfh
ALT 21 U/L 0-31 LabPak-FMO-jfh
AST 19 U/L 0-31 LabPak-FMO-jfh
TOTAL BILI 0.60 mg/dL 0.00-1.00 LabPak-FMO-jfh
GLUCOSE 92 mg/dL 70-105 LabPak-FMO-jfh
TOTAL PROTEIN 6.8 g/dL 5.9-8.4 LabPak-FMO-jfh
LDH
LDH 128 U/L 94-250 LabPak-FMO-jfh
BETA-2- MICROGLOBULIN, SERUM
B2M 1.290 ug/mL 0.002-2.700 LabPak-FMO-jfh

SERUM FREE LIGHT CHAINS
SERUM KAPPA 5.24 mg/L 3.30-19.40 LabPak-FMO-jfh
SERUM LAMBDA 2.38 Low mg/L 5.71-26.30 LabPak-FMO-jfh
KAPPA/LAMBDA, FREE 2.20 High CALC 0.26-1.65 LabPak-FMO-jfh
-- End of Report --

Last edited by lisaobradovich on Sat Mar 01, 2014 3:37 pm, edited 1 time in total.

[Wayne K]

Re: Unsure of lab results

by Wayne K on Sat Mar 01, 2014 1:10 pm

I'm not a doctor, but from what little I know the only thing I see is the low Lambda light chains and the LgG. I don't know the consequences of that because mine are high.
I wish I had your kidney stats.

Last edited by Wayne K on Sat Mar 01, 2014 8:05 pm, edited 1 time in total.

[Multibilly]

Re: Unsure of lab results

by Multibilly on Sat Mar 01, 2014 2:22 pm

First off, I'm not a doc, so please discuss this with yours.

You have a low IgG and a low Lambda free light chain level (which makes your Kappa/Lambda ratio high). Do you have any infections, bronchitis, etc? Infections can cause low IgG levels (I really don’t know what angiontensis II is, but I think you mean angiotensin II, which is a hormone that regulates blood pressure).

These results don’t seem to indicate myeloma to me as you would expect to see an elevated immuglobulin level and/or an elevated free light chain level.

[Ron Harvot]

Re: Unsure of lab results

by Ron Harvot on Sat Mar 01, 2014 6:59 pm

The numbers are barely out of the normal range in the sFLC and even though IGG us low on your immunoglobulin test it is not that far out of normal. Did they do a SPEP? You did not mention that. Also I did not see a CBC so cannot tell if you are anemic or not.

I will assume you are not anemic and the CBC would show normal levels.

The SPEP would show if you had an M Spike. They normally run that test if they suspect multiple myeloma and are doing a sFLC.

So unless the SPEP showed an M spike I agree with Multibilly and don't see anything that would point to multiple myeloma.



Ron

[Dr. Ken Shain]

Re: Unsure of lab results

by Dr. Ken Shain on Sun Mar 02, 2014 10:45 am

The labs are not consistent with a plasma cell disorder (MGUS, smoldering myeloma, or active multiple myeloma).

Isolated suppression of your IgG and Lambda light chains are not consistent with myeloma; as stated already, typically there is an increased clonal expression of immunoglobulins.

Further, your creatinine and calcium were normal. I do not think that you posted your hgb [hemoglobin].

If there are further concerns of multiple myeloma imaging will also be important.

Of course, keep up with your MD to follow-up with anything that may be going on.

[lisaobradovich]

Re: Unsure of lab results

by lisaobradovich on Tue Mar 04, 2014 9:46 am

Hello Dr. Shain and all,

Thanks very much for your replies. My HCT & HGB readings have been higher. I just completed CT scans of abdomen and chest yesterday (as it looks like I'm 7 months pregnant but I'm not & I have pleuritic chest pain). Hopefully the scans will reveal something. I see the hematologist tomorrow, but I really appreciate everyone's follow up with me. Take care and God bless!

Sincerely,

Lisa