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Have Chronic kidney disease, Epilepsy, MGUS, ADHD, back problems and Glucoma. Had pathology. Findings?

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General & Family Physician
Practicing since : 1970
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I HAVE À LAB REPORT ,ITHINK BUT IT SAYS FROM MAYO CLINIC DPT OF MED AND PATHOLOGY 200 1st St Sw Rochester,Mn. So I dont know ,anyway the values seem way off so Ill ask. It reads Component Lambda Free Lt chain S ( reference range 0.5700-2.63) mg/dl and under Value is 3.48 (H) Status- final. THEN Kappa Free Lt chain (reference range 0.3300-1.94) mg/dl Value 300 (H) Status - Final and Kappa/Lamda FLC Ratio (reference range 0.2600-1.65) Value 86.2(H) Status -Final. Can this be correct and what does it mean. THANK YOU.
Posted Thu, 5 Sep 2013 in X-ray, Lab tests and Scans
Answered by Dr. Vasudha Jayant Athavale 2 hours later
Brief Answer:
The report indicates kidney damage & a prompt care.

Detailed Answer:

The free light chain testing is for diagnosis & monitoring of Multiple myeloma & its related disorders.
The Kappa light chain molecule is from chromosome 2 & Lamda light chain molecules are from chromosome 22, & FLC ratio is- ratio of free Kappa light chains/free Lambda light chains.
These are free imunoglobulin light chains produced by our lymphatic system. They are usually metabolized & cleared by kidneys within 2-6 hours,& very little ( Reference range) remains to appear in urine.
However, if the kidney is damaged or diseased they appear in increasing amount in urine. Therefore, indicate severity of kidney damage /disease.
*Increased free Kappa / Free Lambda chains ratio( FLC) shows increased risk of progression to Myeloma from it's precursor conditions.
* Increase production of free light chains shows a bad prognosis in Multiple myeloma.
The results need to be clinically co related.
So I would advise you to understand the urgency & be under an expert
Nephrologist's care & observation.
I hope, I have answered the query up to your satisfaction. Any further query, I will be happy to help you. Take care.

Thank you.

Above answer was peer-reviewed by
Follow-up: Have Chronic kidney disease, Epilepsy, MGUS, ADHD, back problems and Glucoma. Had pathology. Findings? 1 hour later

Well yes I understand the severity,is it à Neurologist I need to see or a nephrologist for my kidneys.I saw à Oncologist about 16 mos ago for a bone marrow test. Because my GP said she found somekind of M protein in my urine.I had à SPEP and a UPEP, AND THEN THÉ bone marrow biopsy. But the Dr said I didnt bave multiple myeloma. Just MGUS (?) And LCDD(?) And he diidnt seem to think it was serious. HOWEVER I seem to recall him saying at the time something about Amyloidosis. I dont know what that is but its been on my chart as a diagnosis for these 16mos. And now when I dont feel well, my GP asked me to have the Oncologist clarifiy what type (apparently there are several) So I did and he said he did not recall that . SO I went online and now my Chart does not show that diagnosis. Nor does it show the lab test any more on my chart. But I had à copy at home ,which is why Ii asked you what it means.Could it have any thing to do with this Amyloidosis?
Answered by Dr. Vasudha Jayant Athavale 2 hours later
Brief Answer:
Onchologist to evaluate tests/condition & guide.

Detailed Answer:

Thanks for your repeat query which indicates your concern & curious nature

Amylodiosis is a group of conditions characterized by excessive protein deposits due to abnormal protein production. In case of Multiple myeloma, there is overproduction of immunoglobin light chains. So amyloidosis is the basic condition of multiple myeloma.

The investigations done in your case in the beginning were on right path. M. protein (Microprotein) found in urine was rightly followed by SPEP (Serum Protein Electrophoresis) & UPEP (urine protein electrophoresis) to be followed by symptoms. Your investigations show kidney damage. Apart from that you may have anemia, neurological, infective or bone involvement. The treatment should have be symptom specific as well as overall control over the disease. Therefore though Nephrologists would treat kidney problems, I would advice you to consult an oncologist first. Oncologist can look at your problem as a whole and accordingly associated with other experts to guide you for further treatment.

I hope I have answered your query to your satisfaction. Let me know if you need clarifications.

Take care & thank you.
Above answer was peer-reviewed by
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