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Have moderate pulmonary hypertension and microvascular angina. Could this be related to FSGS stage 3?

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Posted on Tue, 4 Dec 2012
Question: My name is XXXXXXX and I am 49 years old with a recent diagnosis of moderate pulmonary hypertension and microvascular angina. Could this be related to my FSGS STAGE 3?
Also, I have a positive XXXXXXX nucleolar pattern @ 1:40, Abnormal protein bands 1&2 in my serum and urine (H) negative immunofixation serum and urine for M protein and Beta globulin and gamma globulin peaks... SPEP is normal, dsANA is negative... Could I have a form of Myeloma or Amyloidosis??
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Answered by Dr. Divya Agarwal (6 hours later)
Hi XXXXXXX

It is a possibility that you may have myeloma. You actually need further investigation in the form of a bone marrow exam to rule out malignant cellls. Special stains for amyloid also will have to be done.
The pulmonary Hypertension could be related to a hypercoagulable state.

Amyloid state can be diagnosed by a XXXXXXX scan (scintigraphic imaging ). Rest of your symptoms can be explained by this.

You need to be under a multi-disciplinary team to work out the treatment plan.

Hope I have answered your query. Let me know if I can assist you further.

Wish you good health.

Regards

Above answer was peer-reviewed by : Dr. Mohammed Kappan
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Follow up: Dr. Divya Agarwal (36 hours later)
Thank you for your response. Is it possible that an Autoimmune disease could cause the Abnormal Protein Bands and the elevated C3-C4? I'm losing a lot of protein as my creatinine is 1.11 and my Total protein/creatinine is 1507. My Myoglobulin is 62, CPK is 314 and LD is 214
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Answered by Dr. Divya Agarwal (2 hours later)
Dear XXXXXXX

Thanks again for writing back.

An autoimmune disease can cause generalised increase in globulin levels; but as you have a spike that is less likely. Moreover C3 and C4 levels would be generally low in autoimmune disease and not high because of consumption in immune complexes.

Besides those, the antinuclear antibody (ANA) titer is not very high to suggest an autoimmune disease.

Hope I have clarified all your doubts. Should you have any other doubts/concerns; I will be available to clarify.
If all your queries are answered, please close this discussion.

Regards

Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Divya Agarwal (1 hour later)
So then it is yet possible to have some kind of cancer in the blood or bone marrow?
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Answered by Dr. Divya Agarwal (58 minutes later)
Yes, it definitely needs to be investigated because we cannot afford to miss it.

Regards,

Above answer was peer-reviewed by : Dr. Shanthi.E
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Dr. Divya Agarwal

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Practicing since :1999

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Have moderate pulmonary hypertension and microvascular angina. Could this be related to FSGS stage 3?

Hi XXXXXXX

It is a possibility that you may have myeloma. You actually need further investigation in the form of a bone marrow exam to rule out malignant cellls. Special stains for amyloid also will have to be done.
The pulmonary Hypertension could be related to a hypercoagulable state.

Amyloid state can be diagnosed by a XXXXXXX scan (scintigraphic imaging ). Rest of your symptoms can be explained by this.

You need to be under a multi-disciplinary team to work out the treatment plan.

Hope I have answered your query. Let me know if I can assist you further.

Wish you good health.

Regards