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Worried about high kappa/lambda light chain ratio

by ryan246 on Wed Dec 26, 2012 6:25 pm

I'm a 21 year old male and I've been having odd symptoms (muscle twitching, tremors, back pain, shin pain, foot pain, neck, and hip pain) for about a year and a half now.

One of my doctors found an M protein in my blood a month ago and then did some repeat tests that showed nothing. He brushed it off as a lab error. I asked to be seen by a hematologist anyway, who did more testing about a week ago who says I have nothing to worry about despite having a high kappa/lambda ratio. Now I'm even more confused.

I'd like to add that both doctors are really great and work at the Cleveland Clinic and are just really nice people. I want to believe them, but it's just hard.

Anyway, here are the results (asterisks next to flagged results)

*KAPPA/LAMBDA,FREE,UR -(***high ratio***)
Component Results
Component Your Value Standard Range Units Flag
Kappa Free, Urine 11.1 0.4 - 15.1 mg/L
Lambda Free, Urine 1.1 0.8 - 10.1 mg/L
*K/L Ratio, Urine 10.09 0.46 - 4.00 H

KAPPA/LAMB,FREE,SER - good

IgE BLD - good

IgD BLD - good

Complete metabolic panel - good (aside from slightly low BUN)

B2 Microglobulin BLD - good

Monoclonal Prot BLD - good

*Protein Electrophoresis (1) - (*high albumin?*)
Component Results
Component Your Value Standard Range Units Flag
Protein, Total 7.5 6.0 - 8.4 g/dL
*Albumin for SPE 4.33 3.37 - 4.23 gm/dL H
Alpha 1 Globulin 0.23 0.18 - 0.31 gm/dL
Alpha 2 Globulin 0.68 0.52 - 0.97 gm/dL
Beta Globulin 0.95 0.84 - 1.36 gm/dL
Gamma Globulin 1.31 0.70 - 1.44 gm/dL
Interpretation (Prot Electro) No definitive M protein is identified on protein electrophoresis.
M-Protein Location N/A
M-Protein Concentration 0.00 0.00 gm/dL

Sed rate - good

PROTEIN ELECT RND UR - (good?):
Component Results
Component Your Value Standard Range Units Flag
Protein, Urine Random 11 0 - 20 mg/dL
Albumin, Urine (Prot Electro) 34.8 %
Alpha 1 Globulin, Urine 4.0 >0 %
Alpha 2 Globulin, Urine 18.5 %
Beta Globulin, Urine 26.8 %
Gamma Globulin, Urine 16.1 %
Interpretation (Urine Electro) No definitive M protein is identified on protein electrophoresis.

IMMUNOFIXATION SCREEN, SERUM - good

CBC + AUTO DIFF - good

MONOCLONAL PROT UR - good

*PROTEIN ELECTROPHORESIS - (**M spike**)
Component Results
Component Your Value Standard Range Units Flag
Protein, Total 7.7 6.0 - 8.4 g/dL
Albumin for SPE 4.26 3.37 - 4.23 gm/dL H
Alpha 1 Globulin 0.27 0.18 - 0.31 gm/dL
Alpha 2 Globulin 0.76 0.52 - 0.97 gm/dL
Beta Globulin 0.90 0.84 - 1.36 gm/dL
Gamma Globulin 1.51 0.70 - 1.44 gm/dL H
Interpretation (Prot Electro) An M protein is identified on protein electrophoresis.
Recommend monoclonal protein analysis to further characterize the M
protein.
M-Protein Location Gamma fraction
M-Protein Concentration 0.28 0.00 gm/dL H

The above test was what my original doctor found and then repeated (showing no M protein, I believe) before I asked to see the hematologist. However I show high protein ratio in my urine for Kappa/Lambda.

Is this a cause for concern?

My hematologist said it's not anything to be concerned about because the levels are still within a normal range even if the ratio is off.

I'm really confused. Should I simply trust the hematologist? My family thinks I'm nuts because I won't just drop it.

Thanks so much you guys,

-Ryan

ryan246

Re: Worried about high kappa/lambda light chain ratio

by Stan W. on Thu Dec 27, 2012 10:52 am

If you're that concerned, seek out a myeloma specialist.

Stan W.
Name: Stan
Who do you know with myeloma?: Myself
When were you/they diagnosed?: SMM-April 2012
Age at diagnosis: 58

Re: Worried about high kappa/lambda light chain ratio

by Curious Mind on Thu Apr 24, 2014 10:48 am

Hello,

I would suggest to ask your doctor to do a MRI of the back where you are having a pain. I am going through the same thing, and my doctor did an MRI and found a lytic lesion which damaged my T12 and was causing the pain. Myeloma also causes these lesions which would help to confirm if you have myeloma or not.

Curious Mind

Re: Worried about high kappa/lambda light chain ratio

by Maro on Thu Apr 24, 2014 6:44 pm

I am no specialist but I don't see an M-spike in your results. Plus, it is so unlikely to develop myeloma at 21.

Perhaps it is a good idea to do an MRI. Could simply be something else due to sports or bad move or random back pain. Back pain is the most common thing in the world. I'm 30 and I've got continuous back pain.

Maro
Who do you know with myeloma?: My mom
When were you/they diagnosed?: March 2014
Age at diagnosis: 63


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