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What Does This Urine Electrophoresis Report Indicate?
Question: Hello! Please, please help. I am in need of assistance interpreting some lab results please. I posted a question about this yesterday but have received no answer, and I'm really going through a lot of anxiety right now. Basically I am being tested for multiple myeloma or other monoclonal protein disorders and I have had the following tests done: Serum protein electrophoresis (negative for M-Spike), serum immunofixation (negative for M-Spike), and now I have gotten results back for a 24 hour urine electrophoresis without immunofixation. The results of the 24 hour urine electrophoresis are as follows (lab report also attached also):
Protein, total urine: 6.3 mg/dl No reference range established
Protein, 24 hour calculated: 140.2mg/24 hours (reference range 30-150mg/ 24 hours)
Albumin: 29.1 %
Alpha 1 globulin: 6.0%
Alpha 2 globulin: 20.4%
Beta Globulin: 29.3%
Gamma Globulin: 15.1%
M-Spike: Not observed
I see that an M-spike was not detected, which is obviously great, but from what I read online it seems that a person is not supposed to have globulins in their urine, and my test results are showing that the majority of my urine protein is coming from various globulins (i.e., albumin is only 29% of the total protein). Does this mean that I have Bence Jones/monoclonal free light chain proteins in my urine, or would there have to be an M-Spike detected for these globulins in my urine to be suggestive of that. Please, please help me understand if my results are normal or suggestive of myeloma.
Thank you very much!
Protein, total urine: 6.3 mg/dl No reference range established
Protein, 24 hour calculated: 140.2mg/24 hours (reference range 30-150mg/ 24 hours)
Albumin: 29.1 %
Alpha 1 globulin: 6.0%
Alpha 2 globulin: 20.4%
Beta Globulin: 29.3%
Gamma Globulin: 15.1%
M-Spike: Not observed
I see that an M-spike was not detected, which is obviously great, but from what I read online it seems that a person is not supposed to have globulins in their urine, and my test results are showing that the majority of my urine protein is coming from various globulins (i.e., albumin is only 29% of the total protein). Does this mean that I have Bence Jones/monoclonal free light chain proteins in my urine, or would there have to be an M-Spike detected for these globulins in my urine to be suggestive of that. Please, please help me understand if my results are normal or suggestive of myeloma.
Thank you very much!
Brief Answer:
They are not in the least way suggestive of Multiple Myeloma!
Detailed Answer:
Hi and thank you so much for this query.
I am so sorry to hear about this worries related to myeloma. I have reviewed your information and the attached result PDF report fully. At your age, myeloma is really an exception and rare occurrence and not an expected diagnosis. Making this diagnosis at your age really takes guts. Furthermore, do you have the symptoms of low back pain and anemia which are typical for multiple myeloma, this is probably not a yes. Finally your results are perfectly normal and suggests nothing of a myeloma. This is definitely not suggestive. Other causes to your symptoms should be considered because multiple myeloma is a distractor and not the focus.
I hope this helps. I wish you well. Feel free to ask for more information and clarifications if need be. Above all, thanks for using our services.
They are not in the least way suggestive of Multiple Myeloma!
Detailed Answer:
Hi and thank you so much for this query.
I am so sorry to hear about this worries related to myeloma. I have reviewed your information and the attached result PDF report fully. At your age, myeloma is really an exception and rare occurrence and not an expected diagnosis. Making this diagnosis at your age really takes guts. Furthermore, do you have the symptoms of low back pain and anemia which are typical for multiple myeloma, this is probably not a yes. Finally your results are perfectly normal and suggests nothing of a myeloma. This is definitely not suggestive. Other causes to your symptoms should be considered because multiple myeloma is a distractor and not the focus.
I hope this helps. I wish you well. Feel free to ask for more information and clarifications if need be. Above all, thanks for using our services.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello and thank you very much for your detailed response! I definitely do not have the anemia or elevated calcium that is typical of myeloma (I'll attach my most recent CBC/metabolic panel), but there are several factors that have made me very concerned about myeloma.
I was recently diagnosed with Type 1 Von Willebrand Disease at the age of 31, following a 7 month history of spontaneous petechiae for no known reason. The petechiae are relatively mild (primarily just isolated spots, rather than a 'rash' of them), but constant. While I realize it's possible that the VWD could just be hereditary and largely asymptomatic until now, the fact that there is no known family history of this condition and the fact that I've never had any kind of clinically significant bleeding problem prior to the petechiae does make me worried that it could be the 'acquired' form of VWD, and I do have 2 symptoms that I worry could be characteristic of myeloma:
1) Low back pain- I have sharp pain in the area of the 'dimples' in the lower back that has been fairly constant for the past 2 months. At times this is accompanied by a more aching pain that runs down my buttocks and into the backs of my thighs. The pain never goes past the knee. One thing that is kind of strange about this pain, however, is that the buttock and thigh pain come and go, and they actually switch sides, i.e., sometimes I'll have pain down my right side for several hours that then goes away and switches to the left side, or I might have it in both sides simultaneously. It seems to be highly dependent upon how I'm sitting, and the pain is reliably induced by lying straight leg raises at probably 35 to 45 degree angle. Does this sound characteristic of the low back pain in myeloma or other monoclonal disorders?
2) Neuropathy- For at least 2 years I have experienced somewhat minor paresthesias throughout various parts of my body. They are generally not symmetrically distributed (i.e., the fingertips of my left hand tingle, but those of my right do not, for instance), nor are they constant. While they are 'progressive' in the sense that I have now had them in pretty much every part of my body, they are not 'progressive' in the sense that they aren't really accumulating (i.e., it tends to occur in one part of the body and then leave that part of the body only to crop up elsewhere). Does this possibly fit the pattern of neuropathy typically seen in a monoclonal protein disorder?
Thank you!!!
I was recently diagnosed with Type 1 Von Willebrand Disease at the age of 31, following a 7 month history of spontaneous petechiae for no known reason. The petechiae are relatively mild (primarily just isolated spots, rather than a 'rash' of them), but constant. While I realize it's possible that the VWD could just be hereditary and largely asymptomatic until now, the fact that there is no known family history of this condition and the fact that I've never had any kind of clinically significant bleeding problem prior to the petechiae does make me worried that it could be the 'acquired' form of VWD, and I do have 2 symptoms that I worry could be characteristic of myeloma:
1) Low back pain- I have sharp pain in the area of the 'dimples' in the lower back that has been fairly constant for the past 2 months. At times this is accompanied by a more aching pain that runs down my buttocks and into the backs of my thighs. The pain never goes past the knee. One thing that is kind of strange about this pain, however, is that the buttock and thigh pain come and go, and they actually switch sides, i.e., sometimes I'll have pain down my right side for several hours that then goes away and switches to the left side, or I might have it in both sides simultaneously. It seems to be highly dependent upon how I'm sitting, and the pain is reliably induced by lying straight leg raises at probably 35 to 45 degree angle. Does this sound characteristic of the low back pain in myeloma or other monoclonal disorders?
2) Neuropathy- For at least 2 years I have experienced somewhat minor paresthesias throughout various parts of my body. They are generally not symmetrically distributed (i.e., the fingertips of my left hand tingle, but those of my right do not, for instance), nor are they constant. While they are 'progressive' in the sense that I have now had them in pretty much every part of my body, they are not 'progressive' in the sense that they aren't really accumulating (i.e., it tends to occur in one part of the body and then leave that part of the body only to crop up elsewhere). Does this possibly fit the pattern of neuropathy typically seen in a monoclonal protein disorder?
Thank you!!!
Brief Answer:
These are not suggestive of Multiple Myeloma!
Detailed Answer:
Hi
Thanks for this detailed follow up information. I have reviewed all of it as well as the attached results. This is not MM. Am afraid for some reasons you believe there is something seriously wrong with you and that is the major problem. Your symptoms are not related to this and as such you constantly being worried that you could be having something serious is the problem. Relax and get a settled mind and monitor your symptoms progressively. With a more relaxed and less worried ind, am sure you would be feeling a lot better.
Your pain is not typical of MM. MM pain is localized and dull in nature. Pain radiating to lower limbs is related to the connecting structures of the backbones and not a issue with the bone marrow. Do justice to yourself and be a lot relaxed.
I wish you well.
These are not suggestive of Multiple Myeloma!
Detailed Answer:
Hi
Thanks for this detailed follow up information. I have reviewed all of it as well as the attached results. This is not MM. Am afraid for some reasons you believe there is something seriously wrong with you and that is the major problem. Your symptoms are not related to this and as such you constantly being worried that you could be having something serious is the problem. Relax and get a settled mind and monitor your symptoms progressively. With a more relaxed and less worried ind, am sure you would be feeling a lot better.
Your pain is not typical of MM. MM pain is localized and dull in nature. Pain radiating to lower limbs is related to the connecting structures of the backbones and not a issue with the bone marrow. Do justice to yourself and be a lot relaxed.
I wish you well.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Yes!
Detailed Answer:
Hi,
Am really not sure why you almost got this into your head that you could be having MM. It is really the last of possibilities given all the information we have exchanged/reviewed. Please, be relax and calm about this. Your symptoms are not suggestive. These neuropathy symptoms may be more related to anxiety and a disturbed mindset that a real disease. Build your confidence and carry on, please.
Thanks and let me hear from you!
Yes!
Detailed Answer:
Hi,
Am really not sure why you almost got this into your head that you could be having MM. It is really the last of possibilities given all the information we have exchanged/reviewed. Please, be relax and calm about this. Your symptoms are not suggestive. These neuropathy symptoms may be more related to anxiety and a disturbed mindset that a real disease. Build your confidence and carry on, please.
Thanks and let me hear from you!
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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