MGUS and quite high Free Kappa Light Chain and Kappa Lambda Ratio

Posted by jart @jart, May 15, 2022

The above was found in his blood serum test but follow-up 24 hr urine test showed only 2 free Kappas. Has anyone had experience with this? Does the urine test supersede the serum testing? Either way, is there anything to do other than “watchful waiting?”

BTW, he also has Dysautonomia (Diabetic T2).

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amyboylan1 | @amyboylan1 | Jul 26 1:24am

In reply to @pmm "@tk121 I get a skeletal survey every 6 months. One of the things that is watched..." + (show)

How does one tell if they have bone lesions? Do you need a test and!or are there symptoms to watch for.

kayabbott | @kayabbott | Jul 26 8:05am

In reply to @amyboylan1 "Hi. I was just diagnosed with MGUS and am having a lot of anxiety. Could you..." + (show)

My Kappa is 238 mg/L and Kappa/Lambda is 20. I was diagnosed with MGUS 8 years ago and I am 70. Numbers 7 years ago were 20 and 2.4, and they started creeping up 5 years ago. Risk of MM is 1% each year, so most of us won't get MM and will stay asymptomatic. My oncologist focuses more on CRAB, high blood calcium (indicated de-ossification of bones), renal function, anemia, and bones (SMM and MM can be associated with bone lesions and breaks). So, my Kappa is ramping up but I may still never get to the smoldering stage because my bloodwork is good. BTW, some meds can impact bloodwork numbers if they are metabolized through the kidneys or liver.

amyboylan1 | @amyboylan1 | Jul 26 11:57pm

In reply to @kayabbott "My Kappa is 238 mg/L and Kappa/Lambda is 20. I was diagnosed with MGUS 8 years..." + (show)

Thank you. When you say your bloodwork is good what bloodwork are you referring to?
Thank you so much for writing! I appreciate you so much

amyboylan1 | @amyboylan1 | Jul 27 12:00am

In reply to @kayabbott "My Kappa is 238 mg/L and Kappa/Lambda is 20. I was diagnosed with MGUS 8 years..." + (show)

Do you have an M spike?

kayabbott | @kayabbott | Jul 27 7:11am

In reply to @amyboylan1 "Do you have an M spike?" + (show)

The M spike is at the detection limit. I have IgA Kappa MGUS, which might have less presentation of M proteins.

kayabbott | @kayabbott | Jul 27 7:28am

In reply to @amyboylan1 "Thank you. When you say your bloodwork is good what bloodwork are you referring to? Thank..." + (show)

Well, pretty much everything. Creatinine (a protein from muscle breakdown, or eating too much red meat...) from a urine test is slightly high, but that is related to a med that is metabolized through kidneys and that affects kidney function. Calcium is within normal ranges (increase can indicate that bones are losing calcium, which can point to MM or SMM), my healthy immune (protein electrophoresis) bloodwork is within normal for me, as well as a complete blood count with RBC, WBC, and various other tests. A lot of our waiting games is to evaluate changes, my Kappa/Lambda is ramping up, but other bloodwork is stable and I don't have any symptoms or blood chemistry changes associated with MGUS. M spike is at detection levels, IgG and IgA are normal (I have celiac so IgA can be high if I get glutened). So far, take 2 gm/day of bioavailable curcumin hasn't impacted my Kappa/Lambda or caused symptoms (too much of anything can result in symptoms, even chocolate [darn]). I started that in Jan, just to see if it can suppress the ratio; curcumin is good for inflammation and decreases tumor necrosis factor in other critters.

amyboylan1 | @amyboylan1 | Jul 27 2:17pm

In reply to @kayabbott "The M spike is at the detection limit. I have IgA Kappa MGUS, which might have..." + (show)

I do have M spike.

kayabbott | @kayabbott | Jul 27 2:38pm

In reply to @amyboylan1 "I do have M spike." + (show)

It depends on how high the M spike is, if it is stable or grows through time, and all your other bloodwork and urine analyses. MGUS is quite the balancing act, trying to determine what all the numbers mean. MGUS is a waiting game while you see if numbers go up, down, or other analyses change.

amyboylan1 | @amyboylan1 | Jul 27 3:40pm

In reply to @kayabbott "It depends on how high the M spike is, if it is stable or grows through..." + (show)

Thanks!

mattymatilda | @mattymatilda | Jul 28 1:14am

In reply to @kayabbott "It depends on how high the M spike is, if it is stable or grows through..." + (show)

My m spike is .56 and hematologist said I should not worry because it is so low. I hope that helps.

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