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What Do These Following Lab Reports Indicate?
Question: I have been trying to understand my results but I am so confused.. Polyclonal Gammopathy diagnosed by immunologist.
UPEP Testing
Free Kappa LT chains (0.85)Low 1.35-24.19 Free Lambda LT chains (0.05) Low 0.24-6.66 Kappa/lambda Ratio (17.00) High 2.04-10.37 Prot, 24hr (203.00)High 5.5-150
M-spike (not observed)
SPEP Testing
Creatinine, Serum (0.55)Low 0.57-1.00 Bun/Creatinine Ratio (33)High 8-20 Immunoglobulin A, Qn, Serum (90) Low Immunoglobulin M, Qn, Serum (254) High
M-spike (not observed)
Went to see Hematologist today and she told me that there is nothing wrong and I feel I need a second opinion.
UPEP Testing
Free Kappa LT chains (0.85)Low 1.35-24.19 Free Lambda LT chains (0.05) Low 0.24-6.66 Kappa/lambda Ratio (17.00) High 2.04-10.37 Prot, 24hr (203.00)High 5.5-150
M-spike (not observed)
SPEP Testing
Creatinine, Serum (0.55)Low 0.57-1.00 Bun/Creatinine Ratio (33)High 8-20 Immunoglobulin A, Qn, Serum (90) Low Immunoglobulin M, Qn, Serum (254) High
M-spike (not observed)
Went to see Hematologist today and she told me that there is nothing wrong and I feel I need a second opinion.
Brief Answer:
Hi I would recommend the following
Detailed Answer:
Hi I did review your concern ma'am.
At least from the light chain values that appears in UPEP there doesn't seem to be any problems with that. Although a serum light chain assay may be more definitive in future.
But both the chains are low and so there is no increase in free light chains.
Low IgA and high IgM can occur with a recent infection, so I would recommend a repeat testing after 2-3 months especially if you have recurrent nasopulmonary (Airway and lung) or gatrointestinal (Gut) infections.
Rest your results seem fine. Bun/creat ratio makes sense when creatinine is high so nothing to worry about that and above all M spike is not seen so a likelyhood of plasma cell disorder at this moment is highly unlikely.
Your 24hr protein is a little high and I would recommend a fasting blood sugar and a postprandial 2hr blood sugar test to rule out early diabetes mellitus as microscopic proteinuria can be a common finding with it and can be prevented by early medications and sugar control.
So all in all, I would not worry about any hematological disease right now but recommend
1)Fasting sugar and 2hr-postprandial sugar- to rule out diabetes.
2)Repeat IgA and IgM after 2-3 months if you have recurrent nose or bowel infections.
I hope this helps ma'am.
Let me know if you have any more questions or concerns.
Wish you all the very very best.
Sincerely,
Dr Parth Desai.
Hi I would recommend the following
Detailed Answer:
Hi I did review your concern ma'am.
At least from the light chain values that appears in UPEP there doesn't seem to be any problems with that. Although a serum light chain assay may be more definitive in future.
But both the chains are low and so there is no increase in free light chains.
Low IgA and high IgM can occur with a recent infection, so I would recommend a repeat testing after 2-3 months especially if you have recurrent nasopulmonary (Airway and lung) or gatrointestinal (Gut) infections.
Rest your results seem fine. Bun/creat ratio makes sense when creatinine is high so nothing to worry about that and above all M spike is not seen so a likelyhood of plasma cell disorder at this moment is highly unlikely.
Your 24hr protein is a little high and I would recommend a fasting blood sugar and a postprandial 2hr blood sugar test to rule out early diabetes mellitus as microscopic proteinuria can be a common finding with it and can be prevented by early medications and sugar control.
So all in all, I would not worry about any hematological disease right now but recommend
1)Fasting sugar and 2hr-postprandial sugar- to rule out diabetes.
2)Repeat IgA and IgM after 2-3 months if you have recurrent nose or bowel infections.
I hope this helps ma'am.
Let me know if you have any more questions or concerns.
Wish you all the very very best.
Sincerely,
Dr Parth Desai.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Dr I had an A1 test done and it was in Normal Range no sugar issues....
Brief Answer:
Hi that is good to know. Please repeat urine protein after 1 month
Detailed Answer:
Hello mam,
Thank you for your response.
If your HbA1c and blood sugar tests were normal, then diabetes is not a problem certainly.
So we need to know the cause of microscopic proteinuria. sometimes it can be seen in healthy people too and so the best approach is to repeat it in 1 month's time and if elevated for the second time a further analysis of urine and kidney function is needed.
I hope this helps
Wish you all the best.
Let me know if you have any more questions or concerns.
ALso please provide me feedback on your health mam.
Sincerely
Dr Parth Desai
Hi that is good to know. Please repeat urine protein after 1 month
Detailed Answer:
Hello mam,
Thank you for your response.
If your HbA1c and blood sugar tests were normal, then diabetes is not a problem certainly.
So we need to know the cause of microscopic proteinuria. sometimes it can be seen in healthy people too and so the best approach is to repeat it in 1 month's time and if elevated for the second time a further analysis of urine and kidney function is needed.
I hope this helps
Wish you all the best.
Let me know if you have any more questions or concerns.
ALso please provide me feedback on your health mam.
Sincerely
Dr Parth Desai
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Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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