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What doee "No monoclonal proteins detected" mean?

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Practicing since : 2001
Answered : 257 Questions
I have 3 questions. I received results from immunofixation test which don't appear to be very good. I have no symptoms of multiple myeloma except for iron deficiency anemia. All other blood work(creatinine-normal,protein -normal, calcium-normal,crp-low risk, albumin-normal and all the globulin's normal. 1. My immunofixation test showed an M-Spike too small to be quantified and a IgG kappa monoclonal band present. It also said that the reference range : No monoclonal proteins detected. What does reference range: No monoclonal proteins detected mean? I thought the test showed I did have monoclonal protein detected. 2. The PAL test only had information on abnormal protein band 1 but had no information on abnormal band 2 and 3. Did I have an abnormal band 2 and 3 if there is no information regarding it? It just states DNR following the bands. 3. Does all of this prove without a doubt that I have multiple myeloma?
Posted Thu, 20 Feb 2014 in Blood Disorders
Answered by Dr. Meher Lakshmi Konatam 3 hours later
Brief Answer: not Myeloma Detailed Answer: Sir, before interpretation of any tests, we need to have background knowledge of the disease process, physiology of the body, pathological process going on and biochemical basis behind the test. No test can be interpreted as clinically significant unless clinical condition correlates with the test. You have not written why you underwent these tests. M spike is due to a clone of cells secreting the same protein. it is usually due to Myeloma. Coming to your questions 1) M spike too small to be quantified - that's not significant 2) Second question cannot be answered in isolation. It has no relevance 3) This is very important. Understand that diagnosis of myeloma is not made on electrophoresis alone. Tissue diagnosis is mandatory for multiple myeloma diagnosis. If your bone marrow is normal and there is no abnormal mass anywhere in your body (mean no plasmacytoma), then you need not think of myeloma. In brief, your reports are not conclusive of myeloma. But if your clinical condition warrants, further tests can be done, else you can forget about everything. Regards
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Follow-up: What doee "No monoclonal proteins detected" mean? 1 hour later
Dr. Konatam, The reason for the testing is that I had iron deficiency anemia and the hematologist wanted to rule out multiple myeloma by having me tested with serum protein electrophoresis and an immunofixation test. I want to make sure I understand your answer to my first question. Your answer to my question was that it was not significant. My question was what does it mean when the immunofixation test reports the type of M-spike was a IgG kappa monoclonal protein band which was followed by the statement "Reference Range": No monoclonal proteins detected. Also, the first test reported that the M-spike was too small to be quantified. I was confused that the second test was reporting the type of M-spike but yet was reporting the following; Reference Range: No monoclonal proteins detected. How could the report describe the type of M-spike and then conclude that no monoclonal was detected. What does Reference Range mean? My second question was stated poorly and I apologize for that. My question is can a person have 3 M-spikes on the first test with one blood test?
Answered by Dr. Meher Lakshmi Konatam 2 days later
Brief Answer: nothing to worry Detailed Answer: You need to understand the these proteins are normally present in our body and only when they are abnormally secreted, that is too much of one particular protein which is over and above the normal secretion, it is considered abnormal. since all your proteins are within the normal limits, there is nothing to worry about.
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