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Done With Bone Marrow Biopsy And Having Headache. Not Responding To Medication. Should I Be Worried?

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Posted on Tue, 10 Sep 2013
Question: Can you tell me what light chain myeloma is? And if it differs from just light chain disease.? Or LLCD orage thèse just names for the same thing. Also when you have a skeletal servey done, and it shows no covincing lesions, and only suggestive skull lesions, not conclusive.(thats word for word on THÉ hemalalogy report) WHAT DOES THAT MEAN TRANTSLATED FROM DR. TO PT.ENGLISH. I had a multiple myeloma and now lm having some annoying symptômes I did not have before The worst is a unrelenting headache unlike my usual migraines,and nonresponsive to meds, or any kind, should I be worried?ITunes could just be fatique and WORRY.
doctor
Answered by Dr. dr. Jawahar Ticku (50 minutes later)
Brief Answer:
It is a disorder of plasma cells.

Detailed Answer:
Dear Tarrot Reader,

Sory to note your problem. Light chain disease and and multiple myeloma are practically the variants of the same disease. It is a plasma cell disorder which liberate immunoglobulins which are having two variants light chain and heavy chain.
It effects mainly flat bones of which skull is most important. These erode the bone and cause destruction of the bone forming sort of punched out areas.
As you say you have lesions in the skull it is a matter of concern. I hope before electrophoresis test of serum must have been ordered. This disease is associated with severe anemia giving rise to headache and disturbance in sleep along with general body weakness and lethargy. It is also associated with generalized bony pains. In the latter stages it affects the kidneys as well.
Having told you all this I advise you to visit a hemato oncologist and get the disease verified and get proper treatment.
Please look at it with concern and act as advised. I hope I am clear to you.
Good luck,
Dr. j. Ticku
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. dr. Jawahar Ticku (16 hours later)
Yes,thank you I understand what you are saying. Now let me be XXXXXXX the oncologist that did this work up 16mos ago does not seem concerned. I have gone on line and checked my records and tests results best I can .My UPEP &SPEP showed a monoclonal protein with M spike in the gamma range. M'y B2 Microglolin = 3.65 other than the light chain myeloma, I spoke of and skeletal servey,the 2 lab reports I have show a lamda free light chain S value of 3.48mg/dl, kappa free light chain value of 300 mg/dl,and kappa/lamda FLC Ratio of 86.2, My fasting blood test showed Glucose 102, BUN 33 CREATININE 1.40 ,BUN/Creatinine Ratio 23.6 sodium143 potassium5.1and cholestérol 230. Now I know you cant give out specific advice, but given all Ive told you which is all I know,dont you think the Dr. would suggest some kind of treatment, or in your opinion should I seek a 2nd opinion from another Dr.
doctor
Answered by Dr. dr. Jawahar Ticku (4 hours later)
Brief Answer:
Plasma cell disorder

Detailed Answer:
Dear Tarrot Reader,
Thank you for reverting.

You have not described the skull lesions and your blood count and peripheral smear examination report.
Multiple myeloma is considered positive if there are two major criteria and one minor criteria positive.
Luckily you must be in early stage of this plasma cell disorder and you have normal kidney function which may get damaged in the later stage by the deposition of myeloma protein liberated by these plasma cells.

I feel your bone marrow examination to rule it out. If they are negative and the skull lesions are not osteolytic (Punched out eaten appearance) we can consider that you don't have myeloma, but a chronic plasma cell disorder called MGUS
(Monoclonal Gamopathy Of Unknown Significance) for which there is no specific treatment but supportive treatment,

One good thing I will share with you is that you are without any specific management for past more than one and a half year. Progression of myeloma is faster; in your case as you are without treatment and you haven't progressed as expected in the last year and half, I feel you might not be harbouring myeloma; but the other disease. You should now take a second opinion from a clinical hematologist and get proper advice and line of management

I hope I have been clear to you on the subject.
Truly,
Dr. J. Ticku
Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. dr. Jawahar Ticku

Oncologist

Practicing since :1979

Answered : 490 Questions

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Done With Bone Marrow Biopsy And Having Headache. Not Responding To Medication. Should I Be Worried?

Brief Answer:
It is a disorder of plasma cells.

Detailed Answer:
Dear Tarrot Reader,

Sory to note your problem. Light chain disease and and multiple myeloma are practically the variants of the same disease. It is a plasma cell disorder which liberate immunoglobulins which are having two variants light chain and heavy chain.
It effects mainly flat bones of which skull is most important. These erode the bone and cause destruction of the bone forming sort of punched out areas.
As you say you have lesions in the skull it is a matter of concern. I hope before electrophoresis test of serum must have been ordered. This disease is associated with severe anemia giving rise to headache and disturbance in sleep along with general body weakness and lethargy. It is also associated with generalized bony pains. In the latter stages it affects the kidneys as well.
Having told you all this I advise you to visit a hemato oncologist and get the disease verified and get proper treatment.
Please look at it with concern and act as advised. I hope I am clear to you.
Good luck,
Dr. j. Ticku