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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What do my lab test reports indicate?

Answered by
Dr.
Dr. Anil Parth Desai

Pathologist and Microbiologist

Practicing since :2009

Answered : 593 Questions

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Posted on Wed, 16 Sep 2015 in Blood Disorders
Question: What can this mean.

UPEP Testing    

Free Kappa LT chains (0.85)Low 1.35-24.19  Free Lambda LT chains (0.05) Low 0.24-6.66 Kappa/lambda Ratio (17.00) High 2.04-10.37 Prot, 24hr (203.00)High  5.5-150  
M-spike (not observed)    

SPEP Testing    

Creatinine,  Serum (0.55)Low  0.57-1.00 Bun/Creatinine Ratio (33)High 8-20 Immunoglobulin A, Qn, Serum  (90) Low Immunoglobulin M, Qn, Serum (254) High    
M-spike (not observed) 
doctor
Answered by Dr. Anil Parth Desai 1 hour later
Brief Answer:
Further work up required

Detailed Answer:
Hello mam,
I did review your concern.

Your free kappa and lambda light chains are low and the ratio is altered. In the scenario of low light chain values the increased ratio is less significant and requires regular follow up just to rule out a possibility of underlying monoclonal gammopathy, the chances of which seem to not be significant.

The urine protein is slightly high and this is known as microscopic proteniuria. It is commonly seen in diabetes and I would recommend you get yourself checked for high blood sugar or let me know if you have been analysed for that.

Low serum IgA can be seen in many people and can be due to naturally low IgA levels or mild immunodeficiency. Do you have constant nasal infection or constant diarrhea or gut infection?
Let me know the answers of this questions.

Also let me know if you have any more questions or concerns mam.
Wish you all the best.
Sincerely,
Dr Parth Desai
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Anil Parth Desai 7 hours later
Recent A1 Sugar test was normal and I have recurring Sinus infections..

Also CRP was high
0.0-4.9 it was 14.0
doctor
Answered by Dr. Anil Parth Desai 1 hour later
Brief Answer:
Hello mam, I would recommend the following

Detailed Answer:
Hello mam,
thank you for your reply query.
your recurrent sinus infections can be due to low IgA levels however, we need to follow them serially to see if they remain chronically low to start treatment in terms of certain vaccines, prophylactic antibiotics or possible use of IvIG.
High CRP can be due to recurrent infections.
Since HBA1c is normal chances of diabetes are low but still I would recommend a fasting blood glucose test to completely rule it out.
Also I would recommend that you get a urine protein test done again after 1 month along with urine routine test.
I am not much worried about your kappa and lambda right now since the absolute levels are low and the ratio is hard to interepret and comment upon in this scenario.
I hope this helps
Let me know if you have any more questions or concerns
Wish you all the best
Sincerely
Dr Parth Desai.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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