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My Kappa Light Chain Was 48.4 The Ratio Was 5.6

Posted on Tue, 25 Apr 2023

Question: My kappa light chain was 48.4
The ratio was 5.6
No M spoke was seen and all other labs normal

Follow up: Dr. Shailja Puri (3 minutes later)

My spouse went in for leg pain and fatigue
They did many tests and kappa light chain was done
No protein was found in urine or blood and other labs were all normal
Could this me MGUS or what?

Answered by Dr. Shailja Puri (12 hours later)

Brief Answer:
High kappa chains and high ratio can be due to MGUS

Detailed Answer:
Hello,
Thanks for posting your query on Ask a Doctor forum.
The lab results show elevated kappa chains and high kappa to lambda chain ratio.
High kappa chains and high kappa to lambda ratio in the absence of M-spike can be due to MGUS.
In addition, I suggest you to get immunofixation in serum and urine.
Heavy chain assay should also be done to rule out any other gammopathy.
Symptoms of leg pain and fatigue could be due to some connective tissue disorder.
I also suggest you to consult a rheumatologist for clinical assessment to look for probable cause of fatigue and leg pain.
If you have more queries, I will be glad to answer.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Shailja Puri (1 hour later)

We have seen rheumatologist and all labs were normal -
In labs the serum immundixarion pattern says it appears unremarkable and evidence of monoclonal pattern is not apparent .
In the urine it says
The IFE interpretation was free monoclonal kappa band present
Does this still sound like MGUS

Answered by Dr. Shailja Puri (49 minutes later)

Brief Answer:
Presence of monoclonal protein suggest MGUS

Detailed Answer:
Hello and welcome again,
Presence of isolated kappa light chains is suggestive of MGUS.
You need to remain in touch with your rheumatologist and hematologist.
MGUS has an indolent course and may or may not progress to myeloma or similar disease.
Regular follow up is required and there is nothing much to worry.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Shailja Puri (2 hours later)

Thanks so much for your quick responses.
This doesn’t sound like multiple myeloma ? That’s my fear!

Answered by Dr. Shailja Puri (14 hours later)

Brief Answer:
There is no evidence of multiple myeloma currently

Detailed Answer:
Hello and welcome again,
There is absence of M-spike thus multiple myeloma is unlikely.
MGUS does not necessarily progress to multiple myeloma.
However, regular follow up is required.

Thanks and take cate
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. LAKSHMI