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What Do These Following Lab Reports Indicate?
Question: What might this out of range lab result mean?
"Kappa/lambda light chains free with ratio, urine = 30.58"
Range is 2.04 - 10.37
Normal electrophoretic pattern.
No monoclonal proteins detected.
These three are in range:
Kappa light chain free serum 13.6
Lambda light chain free serum 16.7
Kappa/lambda light chain free with ratio serum .81
Cyclic citrullinated peptide <16
C reactive protein is high 3.0
Range is .0-1.0
eGFR <60
Creatinine .9 Range .61-1.24
Sed rate 3
RA test negative
Bilateral pitting edema and perhaps unrelated chronic cough for about six months.
This test came about after the suspicion of ankylosing spondylitis due to symptoms and HLA-B27 positive.
I have other blood test results in hand.
"Kappa/lambda light chains free with ratio, urine = 30.58"
Range is 2.04 - 10.37
Normal electrophoretic pattern.
No monoclonal proteins detected.
These three are in range:
Kappa light chain free serum 13.6
Lambda light chain free serum 16.7
Kappa/lambda light chain free with ratio serum .81
Cyclic citrullinated peptide <16
C reactive protein is high 3.0
Range is .0-1.0
eGFR <60
Creatinine .9 Range .61-1.24
Sed rate 3
RA test negative
Bilateral pitting edema and perhaps unrelated chronic cough for about six months.
This test came about after the suspicion of ankylosing spondylitis due to symptoms and HLA-B27 positive.
I have other blood test results in hand.
Brief Answer:
A normal electrophoresis rules out plasma cell disorder.
Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.
The interpretation of test reports is as follows:
RA test is negative and cyclic citrullinated peptide is also below 16 or it is negative.
A negative RA and anti CCP antibody rule out rheumatoid arthritis.
No test has been performed for ankylosing spondylitis.
A test for HLA B 27 by PCR needs to be performed to diagnose or rule out ankylosing spondylitis.
Looking at your lab reports, I am of the opinion that a plasma cell disorder is suspected thus serum protein electrophoresis, kappa and lambda free chains and their ratios are performed.
However, a normal protein electrophoresis rules out any plasma cell disorder for all practical purposes.
A raised kappa / lambda free chain ratio is of significance when protein electrophoresis is abnormal or there is detection of monoclonal protein.
Thus, for now there is abnormality in serum proteins.
The creatinine level is within range, however, the eGFR is low (<60). Normal level is between 90-120 mL/min.
Low eGFR suggests some kidney damage.
You need to consult your physician to look for probable cause of low eGFR.
A high CRP occurs due to any inflammatory disorder in body.
It has to be correlated with other test results for interpretation.
Thanks and take care
Dr Shailja Puri
A normal electrophoresis rules out plasma cell disorder.
Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.
The interpretation of test reports is as follows:
RA test is negative and cyclic citrullinated peptide is also below 16 or it is negative.
A negative RA and anti CCP antibody rule out rheumatoid arthritis.
No test has been performed for ankylosing spondylitis.
A test for HLA B 27 by PCR needs to be performed to diagnose or rule out ankylosing spondylitis.
Looking at your lab reports, I am of the opinion that a plasma cell disorder is suspected thus serum protein electrophoresis, kappa and lambda free chains and their ratios are performed.
However, a normal protein electrophoresis rules out any plasma cell disorder for all practical purposes.
A raised kappa / lambda free chain ratio is of significance when protein electrophoresis is abnormal or there is detection of monoclonal protein.
Thus, for now there is abnormality in serum proteins.
The creatinine level is within range, however, the eGFR is low (<60). Normal level is between 90-120 mL/min.
Low eGFR suggests some kidney damage.
You need to consult your physician to look for probable cause of low eGFR.
A high CRP occurs due to any inflammatory disorder in body.
It has to be correlated with other test results for interpretation.
Thanks and take care
Dr Shailja Puri
Above answer was peer-reviewed by :
Dr. Sonia Raina
Ok. Thank you.
This mostly comes as good news, as it apparent due to symptoms that there is some in inflammatory process going on.
I should note that I made an error regarding eGFR, as the result was >60. I pressed the wrong symbol. So that is fine.
My labs came back HLA-B27 positive and I have sacroiliitis and enthesitis. Upon confirmation from an upcoming MRI, the intention is to start Humira.
I just have two concerns moving forward with that:
I have had a chronic cough for six months. I don't smoke and am very healthy (145lbs 5'8"). Before going on an immunosuppressive drug, is it possible and should I attempt to rule out an existing infection?
Additionally, my EF is 55% which is low for my age. I am wondering if that would raise any concern regarding the use of Humira.
Thank You for your assistance.
This mostly comes as good news, as it apparent due to symptoms that there is some in inflammatory process going on.
I should note that I made an error regarding eGFR, as the result was >60. I pressed the wrong symbol. So that is fine.
My labs came back HLA-B27 positive and I have sacroiliitis and enthesitis. Upon confirmation from an upcoming MRI, the intention is to start Humira.
I just have two concerns moving forward with that:
I have had a chronic cough for six months. I don't smoke and am very healthy (145lbs 5'8"). Before going on an immunosuppressive drug, is it possible and should I attempt to rule out an existing infection?
Additionally, my EF is 55% which is low for my age. I am wondering if that would raise any concern regarding the use of Humira.
Thank You for your assistance.
Brief Answer:
Chronic cough needs to be managed before starting Humira.
Detailed Answer:
Hello and welcome again,
Yes, you are right.
Any infectious focus in body should be treated before starting treatment with Humira.
A cough for last six months is likely to be due to chronic irritation of throat or some respiratory problem.
I suggest you to consult an ENT specialist for examination of the throat.
Chronic irritation of throat can occur due to post-nasal drip secondary to sinusitis.
It can even occur due to reflux of gastric contents into throat.
Treatment of chronic cough is required before you could start with Humira.
Humira does not have any adverse effect on cardiac function thus you may start with the drug with low EF.
I am sure you will undergo general physical examination before the drug is administered by your treating doctor.
Thanks and take care
Dr Shailja Puri
Chronic cough needs to be managed before starting Humira.
Detailed Answer:
Hello and welcome again,
Yes, you are right.
Any infectious focus in body should be treated before starting treatment with Humira.
A cough for last six months is likely to be due to chronic irritation of throat or some respiratory problem.
I suggest you to consult an ENT specialist for examination of the throat.
Chronic irritation of throat can occur due to post-nasal drip secondary to sinusitis.
It can even occur due to reflux of gastric contents into throat.
Treatment of chronic cough is required before you could start with Humira.
Humira does not have any adverse effect on cardiac function thus you may start with the drug with low EF.
I am sure you will undergo general physical examination before the drug is administered by your treating doctor.
Thanks and take care
Dr Shailja Puri
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. Arnab Banerjee
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