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This question was answered on Fri 06, Jun 2008 08:49pm by Dr Paul S, MD

multiple myeloma, non-hodgkin's disease, - abnormal blood work, high levels of beta-2, very tired, hurt everywhere - what other possible auto-immune disease could it be


    
Asked by ninibini (Female; 53; sinus operation, hysterrectomy - normal blood pressure, no diabities; Relevant drugs:crestor 20mg/ kardegic/plus thyroid medication at .25 ) on Tue 03, Jun 2008 03:13pm

i am a 53 year old woman in generally good health, non-smoker; very little alcohol consumption; reasonably active (don't own a car, i walk everywhere)/ 1 son, 19 and 1 daughter, 11. just received my blood work, have had a high sedimentation level for several years, assumed it was arthritis. - lastest results show / sedimmmentatiom 1st hour at 42mm aand 2nd hour at 75 mm/proteine C reactive at 13,7mg/l - immunoglobuline G at 25,30g/l - beta globulines at 13,5 g/l - y globulines at 5,8 g/l - plus a presence of an immunoglobuline monoclonale type:=-IgG Kappa - acth matin (ECLIA - Modular _Roche) of 69.70 ng/L/ and 15.33 nmol/L. my question to you is would you consider that i could possibly have "multiple myeloma" or "lyphoma"? i have an appointment with my specialist in 2 days and would like to prepare myself, plus after extensive research on the net - it keeps coming up - multiple myeloma. no one in my family has this, however my mother is being treated for stage 2 pancreatic cancer and has undergone a WHIPPLE, she is 83 and 10 years ago,my fathe rhas had colon cancer and he is now 90. i just had a colonoscopy and no polyps found. thanks for your insight and i realize that more tests are necessary for an accurate diagnosis. will problably have bone marrow test soon. thanks again. by the way, i am a white woman and it seems that all i read is that this affects black men most often and the elderly.

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Answer by Dr Paul S, MD  on Fri 06, Jun 2008 08:49pm:

Hi there. Thanks for the clarifications. From what you have described, you have two fractions of globulins that are high: the IgG and the Beta-2 globulins. This finding is unlikely to be reflective of multiple myeloma (MM) since MM usually presents with a striking high levels of a single fraction (either marked increase of IgG alone or the Beta-2 alone). This is termed as the monoclonal gammopathy of MM. Also, MM is not just diagnosed using these labs. Other findings would include anemia, kidney problems, and presence of bone lesions especially in the skull and spine. Back pain is also a manifestation. MM is also more common in persons in their 60's. Lymphoma presents with a mass or nodules usually in the areas with lymph nodes (neck, axilla, inside the abdomen, inguinal area). These laboratories are in no way indicative of such. I hope that your consult with the specialist will be fruitful. If you have symptoms pertaining to MM, then I agree that a bone marrow biopsy may be in order. Wishing you all the best. Regards and God bless.

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Follow up:

Request for Clarification by Dr Paul S, MD on Thu 05, Jun 2008 02:30am:
Hi there, can you write the normal referrence values coinciding with the tests done?  These are usually
written just across the actual results.  Different laboratories may have different normal values.  Thanks.
Clarification by ninibini on Thu 05, Jun 2008 05:08am:
ACTH matin (ECLIA - Modular - Roche) 69.70ng/L - ref.5 to 60ng/L and 15.33nmol/L - ref. 1.10 to 13.2 nmol/L
///////sedimentation; first hour 42mm - ref. inf.to 10 and second hour 75mm - ref. inf. to 20/////calcium -
99mg/L - ref 90 to 104//////// proteine C reactive 13.7mg/L - ref. inf. to 6.0//////// immunoglobuline G is
25.30g/L - ref. inf. to 6.8 to 15.0/////// beta-2-globulines is 13.50g/L ref. is 4.0 to 9.0/////
gammaglobulines is 5.8g/L and ref.is 7.0 to 14.0//// albumine is 44g/L and ref. is 38.0 to 46.0////// and the
IgG protein value is 25.3 and IgM value is 0.96 and the IgA value is 1.2 //////////// hope this gives you a
better base to work from///// thanks
Clarification by ninibini on Thu 05, Jun 2008 05:08am:
ACTH matin (ECLIA - Modular - Roche) 69.70ng/L - ref.5 to 60ng/L and 15.33nmol/L - ref. 1.10 to 13.2 nmol/L
///////sedimentation; first hour 42mm - ref. inf.to 10 and second hour 75mm - ref. inf. to 20/////calcium -
99mg/L - ref 90 to 104//////// proteine C reactive 13.7mg/L - ref. inf. to 6.0//////// immunoglobuline G is
25.30g/L - ref. inf. to 6.8 to 15.0/////// beta-2-globulines is 13.50g/L ref. is 4.0 to 9.0/////
gammaglobulines is 5.8g/L and ref.is 7.0 to 14.0//// albumine is 44g/L and ref. is 38.0 to 46.0////// and the
IgG protein value is 25.3 and IgM value is 0.96 and the IgA value is 1.2 //////////// hope this gives you a
better base to work from///// thanks

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