Posts by Michelle Morris74

Maria Fisher46 said:Your mother has monoclonal gammopathy—that’s all those results tell us. Essentially, this finding (monoclonal IgG kappa) could point to several different conditions. The primary suspects are multiple myeloma and its various forms, or MGUS (Monoclonal Gammopathy of Undetermined Significance). MGUS is a condition where there's a certain percentage of patients who eventually progress to multiple myeloma—we're looking at about a 1% annual risk—but for everyone else, it stays benign and doesn't require treatment.

Based strictly on that one lab, we can't distinguish between the two options. However, the fact remains that MGUS—the more favorable scenario—is asymptomatic. You, on the other hand, mentioned that your mother is exhibiting "all the symptoms of multiple myeloma."

She also deals with rheumatoid arthritis—which might involve secondary Sjögren's syndrome or an overlap with systemic lupus erythematosus, given the positive anti-SS-A and SS-B antibodies (though, keep in mind, these can also show up in RA cases)—so that definitely needs to be factored into the clinical picture. But, if she truly is presenting with symptoms consistent with multiple myeloma, then that diagnosis becomes much more likely.

Without the specific tests I mentioned earlier, it's impossible to say for sure whether we're dealing with multiple myeloma or not.

Thank you so much for the response. We actually just had the bone marrow biopsy done, and I've included the results below. If you're able to help me make sense of them... maybe we can finally get some clarity? I am desperately hoping it turns out to be MGUS—I know that doesn't require treatment, just monitoring—and we are praying with all our hearts for that outcome. Here is the full content of the bone marrow biopsy report:

Erythropoiesis: present, morphologically normal
Granulopoiesis: present, all developmental stages present
Lymphocytic cells: not increased
Plasma cells: not increased
Thrombopoiesis: present, releasing platelets
Extramedullary cells: not swollen

MYELOGRAM

GRANULOPOIESIS: NORMAL
promyelocytes: 2 (1.0-6.0)
myelocytes: 19 (8.0-15.0)
metamyelocytes: 8 (9.0-25.0)
non-segmented: 12 (9.6-15.3)
segmented: 21 (6.0-12.0)
eosinophilic granulocytes: 1 (0.0-4.0)
lymphocytes: 20 (11.0-23.0)
plasma cells: 2 (0.4-3.9)

ERYTHROPOIESIS: NORMAL
basophilic erythroblasts: 2 (1.0-5.0)
polychromatic erythroblasts: 1 (5.0-20.0)
acidophilic erythroblasts: 12 (1.0-15.0)

CYTOCHEMISTRY
DCS: non-seg 1, seg 66, eo 1, baso 1, mono 4, ly 27, Tr ++

LE/RBC ratio 5.5:1 (norm. 3-4:1)

Conclusion: hypocellular bone marrow with white/red cell ratio.

Thanks again for your previous answer, and thank you in advance for your help with this next one.

I’m looking for some help interpreting these lab results. My mother has rheumatoid arthritis—which is already enough to deal with—but because she was very thorough in describing all her symptoms to her rheumatologist, there's now a suspicion of multiple myeloma. Her serum protein electrophoresis showed a gamma level of 18.3 (standard range is 8.9 to 13.5), while her albumin came in at 52.4 (standard range is 55.8 to 66.1). They also detected an M-protein in the gamma fraction. Because of that, she had bloodwork done specifically for immunoglobulins; I'll paste the full results here:

Immunoglobulin levels

The immunofixation serum protein electrophoresis noted: Monoclonal IgG kappa type
Her autoimmune serology (ENA-screen) came back positive
Anti-SS-A/Ro (60 kDa) 131 (normal up to 30)
Anti-SS-A/Ro (52 kDa) 179 (normal up to 30)
Anti-SS-B/La 66 (normal up to 30)
All other antibodies were normal
ANF: Negative
CA 242 tumor marker is normal... 0.8

I know she’ll eventually need a 24-hour urine test and a bone marrow biopsy—those are the next logical steps—but in the meantime, could anyone provide an opinion or an analysis of these numbers? The real issue is that she’s exhibiting all the classic symptoms associated with that malignancy, which is why the doctor flagged it—and frankly, we are absolutely terrified. I am asking from the bottom of my heart if you can offer any insight based on these specific findings.