investigations to rule out myeloma - Ruled out Myeloma but concerned about renal function

Hi, Sorry if i dont explain these lab results well. I cant understand the layout of the results on the form!Recently i went to the doctor due to extreme fatigue, aches, heel pain,occasional nocturia, shocking restless legs , peripheral neuropathies and intermittent ammonia breath.Blood tests revealed monoclonal IgG Kappa (immunofixation) with quantitation 4g/L (Range <0.1). And also some Kappa Light chains (Bence Jones kappa) in my urine -immunofixation. In the urine i think it was only a tiny amount... of 30% as abnormal band as % of protein. Or abnormal band protein -<0.01 (range <0). I am waiting on results from the bone marrow asp/biopsy. Obviously the doc is ruling out myeloma but what i am also concerned about is my renal function. I am 33 years (F) old and my estimated GFR is 78 and has been for the last three years (since i also notice now that my total protein has been elevated-but not then investigated). Can these proteins be harming my kidneys and is my GFR satisfactory? I dont think i will have myeloma (and i hope i dont)but if it is MGUS, does this cause the symptoms i have and can it effect my kidneys? And what are the statistics for me as a 33 year old with MGUS , progressing to myeloma one day? thanks heaps, me. PS my test results are in australian values

Hi, I apologize for the late reply. You are a 33 old lady, with complaints of fatigue, body ache, and "peripheral neuropathy". Tests have revealed kappa-restricted IgG 4 g/L, and mild levels of kappa light chains in the urine. Thus you do not meet the criteria of multiple myeloma. Your concerns are about 1. Your "low" GFR level, and 2. chances of progression of monoclonal gammopathy of undetermined significance (MGUS) to overt multiple myeloma. Let us examine both issues. The glomerular filtration rate or GFR is a measure of kidney function. It measures the amount of fluid that the renal glomeruli can filter in a minute, and the normal range is 100 to 120 ml per min, or about 60 ± 10 mL/min/m2 for women. Your GFR is 78, and you have not specified the units. Please check if the unit is ml/min or ml/min/m2. In either case, your present GFR is pretty good, and not a cuse of worry at this point. MGUS is common in society, 1% of people over the age of 50, and 10% of people over 75 yrs have MGUS. MGUS does not require treatment. Large studies that have tracked people with MGUS for decades have concluded that chances of development of multiple myeloma is only about 1%. I wish you all the very best. I would be interested in hearing about the results of your bone marrow report. Suggested Reading: http://qjmed.oxfordjournals.org/cgi/reprint/90/11/653.pdf http://www.merck.com/mmpe/sec17/ch226/ch226b.html#sec17-ch226-ch226b-54 Harrison's Principles of Internal Medicine, 16th Ed, McGraw Hill. Ch 98, Plasma Cell Disorders by Dan Longo and Kenneth Anderson.

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investigations to rule out myeloma - Ruled out Myeloma but concerned about renal function

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