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Low Albumin in blood, high protein in urine: VTD preferred?

by anindita on Thu Oct 11, 2012 8:34 am

Hello,
My father has been detected with multiple myeloma 3months back with plasma cell of 21%. Blood counts, rbc, wbc, hemoglobin, calcium etc are ok. only thing is he is having high amount of protein in urine also (IGA). due to low albumin (1.8) in his blood his feet has swollen. Otherwise there is no complications. He is undergoing VTD for last three months. Till date not much improvement in swelling. Not any more deterioration as well.
Anybody aware of such low albumin level in multiple myeloma without any other symptoms? is VTD okay for such multiple myeloma symptoms? Dr prescribed to increase protein intake. For 3 more months the VTD will continue.

Kindly respond.
Anindita

anindita

Re: Low Albumin in blood, high protein in urine: VTD preferr

by Dr. Peter Voorhees on Fri Oct 12, 2012 1:40 am

Dear Anindita,

I would be highly concerned that your father's multiple myeloma is complicated by amyloidosis. This is a situation where the antibodies produced by the myeloma cells gradually deposit in organs, eventually leading to damage. The kidneys are commonly affected, leading to high amounts of protein being spilled in the urine. This leads to low albumin levels and swelling.

I would ask your father's physician(s) if this has been evaluated. If not as of yet, it is something to strongly consider.

Good luck!

Pete V.
Dr. Peter Voorhees
University of North Carolina at Chapel Hill

Any advice provided in these postings is based on a very limited amount of information. There is no substitute for the care of your oncologist/hematologist. Therefore, all suggestions should be discussed with your treating physician. None of the comments presented here are meant to replace the evaluation of a patient by a knowledgeable physician.


Dr. Peter Voorhees
Name: Peter Voorhees, M.D.
Beacon Medical Advisor

Re: Low Albumin in blood, high protein in urine: VTD preferr

by anindita on Fri Oct 12, 2012 10:52 am

Dr Peter,

Thanx for such an important information.

What is the treatment for this? Currently he is under VTD for last 2.5 months having 3 Velcade per month. Albumin level increased in blood from 1.3 to 1.8 although the swelling has not come down. In July BMB shown 21% plasma cells. He does not have any other complications.

I will ask his physician certainly in the next visit. Meanwhile it would be helpful to know if there is any other treatment for this?

Best regards,
Anindita

anindita

Re: Low Albumin in blood, high protein in urine: VTD preferr

by anindita on Fri Oct 12, 2012 11:43 am

Is there any way to differentiate between multiple myeloma and amyloidosis?

My father has normal blood counts and calcium and does not have any lesion. Is he not a myeloma patient at all? Or is amyloidosis is a sub group of myeloma?

anindita

Re: Low Albumin in blood, high protein in urine: VTD preferr

by Beacon Staff on Fri Oct 12, 2012 12:58 pm

Dear Anindita,

Amyloidosis is a condition that often occurs in patients with multiple myeloma, but it also can be a completely separate condition.

You can read more about amyloidosis in myeloma patients here:

http://www.myelomabeacon.com/news/2010/09/15/multiple-myeloma-associated-amyloidosis-what-every-patient-should-know/

If you do an Internet search on the keyword "amyloidosis", you will find a number of useful overviews of what the condition is. This page has some basic information:

http://www.nlm.nih.gov/medlineplus/ency/article/000533.htm

Best of luck to you and your father.

Beacon Staff

Re: Low Albumin in blood, high protein in urine: VTD preferr

by anindita on Wed Oct 17, 2012 11:29 am

I forgot to mention that my father had protein in urine back in 2004. At that time there were no symptoms at all and general physician did ignore the protein in urine and since then it remained untreated. Recently in march 2012 thankfully we visited hematologists and multiple myeloma was detected. Till date, his kidney function is okay. Although pedal edema is seen since march 2012.

Is amyloiosis can last so long 2004 to 12???

I have had a word with his oncologists by mail, he told my father probably is not having amyloiosis. We will meet him next week. Lets see how things progress.

Regards,
Anindita

anindita

Re: Low Albumin in blood, high protein in urine: VTD preferr

by anindita on Fri Dec 21, 2012 11:27 am

My father (age )60 had the plasma cell count on July 2012 - 21% and light chain ratio as 0.006 only. After 5cycles of VTD his ratio has improved to 0.56; (0.25 to 1.65 being normal.)

But his serum albumin has not improved much, from 1.3 to 1.9; still very low from normal range. His haemoglobin, platelet, calcium, kreatinine etc are normal.

Oncologist suggested today to visit nephrologist to see how the nephrons in kidney are functioning so that this much protein is leaking out.

My father is otherwise doing good, no side effects, mainting his regular activities.
Can anyone throw some light onto it??? how this protein leaking can be stopped?? Will be of much help.

anindita


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