Interpreting Myeloma tests- case studies

We continue from the first myeloma video to apply some principles to real life case studies of myeloma and immunoglobulin related abnormalities. This video is strongly recommended for GP's and GP trainees as well as those in orthopaedics and general medicine

[@glksivakaran]

Hi sir thank you so much for your lecture sad to see you re not uploading new videos

[@tj6544]

Great video, patient E is very much like me when I was diagnosed except that my Paraprotein was 5

[@JWB671]

You can’t be light chain MM like patient E if you have a paraprotein of 5.

[@robertmiller3810]

Thank you for posting this, so I can actual see test results. I’ve been classified as having Kappa Light Chain IgM-MGUS, that seems to be slowly progressing towards NHL or WM. I had a brother who died from MM. I’m in very poor condition health wise because of multiple birth defects, so my outlook is
grim at best. I’m a male,79 my brother was 72 at death. I had two precancerous moles were removed in 2013, one by the left side of my nose, the other in the left side of my neck in the back. I see an Oncologist and Hematologist bi-yearly. Any advice for me, my bloodwork showing an slow upwards climb in this wait and see method?

[@swaradnikulkarni2538]

If LAMBDA is 122.52 & so ratio is 0.14 but IgG is high 19.12
Paraprotein is 6.2, TSH 6.6 , ESR 34, Vita D3 v low 14.
fatigue, back neck shoulder pain, numbness tinkling , all since 6-8 months, acid reflux- since 5 months Is this Myeloma ?

[@rathikadikshit9142]

Can kappa light chains and kappa/lambda ratio increase in chronic inflammatory conditions and/or infection ?

[@yogamon]

Yes, kappa and lambda free light chains can increase due to immune system activation like infections or autoimmune disorders. The ratio typically stays normal in polyclonal responses. Monoclonal proteins excreted by cancerous cells cause the ratio to get abnormal-typically.

[@rathikadikshit9142]

@@yogamon but my doctor said slight elevation in the ratio can be caused by polyclonal response

[@yogamon]

@@rathikadikshit9142 that can be true. No marker is 100% perfect. It depends on the clinical picture and what all the other tests say.

[@anamarijasanseovic5014]

First case is not myeloma then...?

[@colinheaton6934]

No it's more liver related disease is my understanding...my igg is 18 and I've suspected myeloma but he says anything under 30 is mgus its all rather confusing

[@kelly-annoharrow9868]

​@@colinheaton6934hi, did you manage to get a diagnosis?