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What Do My Lab Test Reports Indicate?

Posted on Tue, 16 Aug 2016

Question: I have been treated for Lyme with postive ELISA and WB, symptoms were neurological, manythings improved, but my neuropathy in my feet continues with painful flares, and I have been having significant memory loss, bladder control, issues, no incontinence though. I have had a positive test for Bartonella and and continue with another course of antibiotics with about 50% improvement except for the cognitive issues. I've had severe daytime drowsiness.
So recently to rule out amyloidosisI had and SPEP done, normal serum PE, and IFE. But Kappa light chains elevates to 39, lamda normal at 17, and a k/l ratio of 2.1.
What are the next steps. I uploaded the full lab results

Does my continuing neuropathy and cognitive symptoms count as symptomatic in terms of Amyloidosis, MGUS or myeloma?

Answered by Dr. Hardik Sanghvi (1 hour later)

Brief Answer:
You have light chain disease.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.

You have kappa/lamda ratio of 2.1 which suggest kappa chain myeloma. It is light chain myeloma and many times there is no M spike as in your case.

You have neuropathy and cognitive symptoms. However it may be due to amyloidosis, your previous illness or some other reasons.

Please go for Haemoglobin, Blood urea, Creatinine, serum albumin, calcium.

You should also go for bone scan/MRI spine to rule out any lytic lesion.

If you have any other end organ damage or lytic lesion then only it is considered as symptomatic.

Neuropathy and cognitive disease does not mean symtopmatic disease. It can be due to other disorder or amyloidosis.

For neuropathy you can take vitamin B12 and pregabalin like drugs.

Please provide me above mentioned report so that I can help you to plan further.

Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer.
Thanks for using health care magic. Wish you a very good health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Hardik Sanghvi (10 hours later)

'what are the risk factors for as you called it "light chain disease"

I uploaded a second lab with my CBCs from the spring, perhaps that will help

I found this linking lyme to cryoglobulinemia and kappa light chains
http://www.YYYY.nlm.nih.gov/pmc/articles/PMC0000/

one more. awaiting small nerve biopsy, would that show end organ damage?

true to form, I forgot to mention I do get unexplained bruises on mt legs and arms, and have a spot of discoloration, like a bruise that has been there for over 1 year.
and I treat the pain from the the neuropathy well with vitamin b complex and cannabis extract

Answered by Dr. Hardik Sanghvi (16 hours later)

Brief Answer:
It can progress to multiple myeloma, amyloidosis or other disease.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.

Risk factors are progressiion in to multiple myeloma, amyloidosis or other disease.

Your Lyme disease is not related.

Nerve biopsy doesn't indicate end organ damage.
End organ damage can be measured by creatinine level.

You also have some bruices. it can be due to some coagulation abnormalities or other disease. Go for coagulation profile once.

please update me your nerve biopsy report.

Continue with your vitamin B12 treatment as per advice.

Thanks for using health care magic. Wish you a very good health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Hardik Sanghvi (11 hours later)

you've been great help to me reliving anxiety. the knowledge helps. one last question: with my symptoms is this kind of free light chain finding ever clinically insignificant?

Answered by Dr. Hardik Sanghvi (7 hours later)

Brief Answer:
No its not clinically insignificant.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.

Your light chain disease is not clinically insignificant. It is definitely significant.
Right now your kidney is functioning properly but ultimately kidney will affected by light chain disease.

So you need definite treatment.

Prognosis depends on age, kidney function, associated multiple myeloma and many other factors.

So it is significant and you need treatment.

Hope I have answered your question. If you have any doubts then feel free to ask me. I will be happy to answer. Thanks for using health care magic. Wish you a very good health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Hardik Sanghvi (8 hours later)

I have a standing order for vit D, serum calcium, phosphorus and parathyroid due to my antibiotic therapy. would those results be informative? I can get the test today.

Answered by Dr. Hardik Sanghvi (16 hours later)

Brief Answer:
Yes you can get test today.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
calcium level is very important.

Vitamin D and parathyroid level are useful in calcium regulation. Its level is important in high or low calcium level to find the cause.

So go for the test.

Hope I have answered your question. if you have any doubts then feel free to ask me.
I will be happy to answer.

Thanks for using health care magic.
Wish you very good health.

Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar