Multiple Myeloma

Multiple myeloma, alias Kahler's disease, is a type of blood cancer that affects the plasma cells. The signs and symptoms of multiple myeloma include bone pain, loss of appetite, frequent infections, weight loss, and weakness in the legs. The exact cause of multiple myeloma is not known.

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What is an immunofixation test?

Query: Hello doctor, I am asking this question on behalf of my dad, who is 60 years old, 5 feet 9 inches, and 173 lbs. He was recently diagnosed with stage three chronic kidney disease. He also recently received an abnormal result on a serum immunofixation test, which I know can be an indicator of multiple...  Read Full »


Dr. Parth R Goswami

Answer: Hello,Welcome to icliniq.com.As your dad has a chronic kidney disease, he is having nephropathy of the kidneys. We should look out for the cause. It could be high blood pressure or uncontrolled diabetes. He may require dialysis in the later stages.In chronic kidney diseases, active conversion of vi...  Read Full »

How to find the stage of multiple myeloma?

Query: Hi doctor, My 97 year old mother, who is in a nursing home, is more tired and feeling unwell. A blood test has shown she has likely got multiple myeloma. She had left-sided paralysis from a stroke six years ago. She cannot speak, and she is slow in understanding and writing, but she has no dementia...  Read Full »


Dr. Parth R Goswami

Answer: Hi, Welcome to icliniq.com. Sorry to hear about your mother's condition. I have read all the test values that you have mentioned. From which, I can see that her total protein is high and albumin is low with elevated gamma globulin. Immunofixation electrophoresis is the best test to detect plasma ce...  Read Full »

Can hypercoagulability occur with elevated globulin level?

Query: Hi doctor, My father is a 70-year-old male with BPH and well-controlled type-2 diabetes. He has been fatigued for six weeks. He was found three weeks ago to have mild anemia (Hb-12 gm/dL) and macrocytosis with a mildly low Vitamin B12. He started Vitamin B12 but had a slow progression of fatigue an...  Read Full »


Dr. Parth R Goswami

Answer: Hello, Welcome to icliniq.com. Following is my opinion for your asked question. We cannot say multiple myeloma conclusively just now. Impaired kidney function also can cause anemia, fatigue, and low platelet count. Diabetes could have produced such renal dysfunction. However, serum immunofixatio...  Read Full »

How to treat multiple myeloma at home?

Query: Hello doctor, My father is 54 years old. His weight is 62 kg, and his height is 168 cm. He was hospitalized last year because of lower back pain after sneezing. He was diagnosed to have lumbar strain versus HNP. He was again hospitalized three months back and was diagnosed with compression fracture...  Read Full »


Dr. Parth R Goswami

Answer: Hello, Welcome to icliniq.com. In the attached report (attachment removed to protect the patient's identity), there is a spike in the gamma region. Monoclonal immunoglobulin has increased. So it seems to be multiple myeloma. His creatinine and calcium are also increased. So treatment needs to be...  Read Full »

Are raised kappa levels seen in multiple myeloma?

Query: Hi doctor, I have been diagnosed with CKD, and my GFR is 52. My recent blood test results show the following information. Kappa QNT free LT chains 41.60 mg/dL, lambda QNT free LT chains 0.96 mg/dL, KAP/LAM free LT chain ratio 43.33 and hemoglobin 15.8 g/dL. I was also detected with vitamin D deficie...  Read Full »


Dr. Anshul Varshney

Answer: Hi, Welcome to icliniq.com. We are here to help you. A diagnosis of any disease is based on the symptoms and laboratory work. I need the following details to help you better. Why were these tests performed? Do you have bone pain or any night sweats or any weight loss? Please attach a scanned cop...  Read Full »

Can multiple myeloma be diagnosed only by doing blood tests and X-rays?

Query: Hi doctor, I am a 63 year old male. I have been recently diagnosed with multiple myeloma. My doctor, who is listed as a hematologist or oncologist, said that I must undergo chemotherapy asap. His diagnosis was based solely on bloodwork and a full skeletal x-ray. There was no MRI or PET scan or bone...  Read Full »


Dr. Sagar Ramesh Makode

Answer: Hi, Welcome to icliniq.com. Blood work can strongly suggest myeloma; however, marrow biopsy is needed. But, one can fairly be sure about the diagnosis. Before starting treatment one will need the bone marrow biopsy. Also, bony lesion if visible on x-ray, then one may proceed without MRI or PET scan....  Read Full »

What are the further investigations done to confirm IgM MGUS?

Query: Hi doctor, I am 46 years old and I was diagnosed with IgM MGUS at low concentration last month. I am worried about the bone marrow results coming next week. My GP referred me to a hematologist. I do not have the symptoms of WM but hematologists suggest a bone marrow biopsy and CT scan excludes lymp...  Read Full »


Dr. Kamal Kant Sahu

Answer: Hi, Welcome to icliniq.com. Based on the reports, you have IgM MGUS (monoclonal gammopathy of undetermined significance). But we need to confirm it by doing a bone marrow biopsy and it should be less than 10 % clonal lymphoplasmacytic or plasma cells in the bone marrow. About one percent of people...  Read Full »

Whom should we consult for my mom's bone TB?

Query: Hi doctor, My mom is a CKD patient and undergoes dialysis. For the past two months, she is having a back pain. On visiting an orthopedician, he suggested an MRI of dorsal spine, which shows D5-D6 eroded and the doctor is suspecting a bone TB. So, I am concerned about which doctor to approach. Shoul...  Read Full »


Dr. Bharat Patodiya

Answer: Hello, Welcome to icliniq.com. I understand your confusion in today's world of information. I think the best option is to approach a spine surgeon, who can get an appropriate biopsy. Based on the biopsy, further specialist can be decided. Because, bone erosion could also be due to non-tuberculosis d...  Read Full »

Why do I have confusion and significant short-term memory loss?

Query: Hi doctor, I recently had a serum PEL IFE with a free light chain analysis. PEL and IFE were normal, but elevated kappa 39.86 mg/L and lambda 19 mg/L with the ratio of 2:1. The test was done due to persistent and worsening polyneuropathy. Currently, I am having confusion and significant short-term m...  Read Full »


Dr. Anshul Varshney

Answer: Hi, Welcome to icliniq.com. We are here to help you. These reports need evaluation for the cause of multiple myeloma. However, I do not strongly suspect it based on these reports as a lot of the asymptomatic general population has an elevated kappa chain with no significance. Still, a bone marrow e...  Read Full »

How to cure my skin rashes?

Query: Hi doctor, I have rashes similar to the rash of SLE, swollen, painful and redness around the eyes, severe fatigue and muscle weakness. These symptoms occurred a few months back after I had an intestinal infection. The doctors suspected it to be dermatolysis too, thus having a skin biopsy done tomorr...  Read Full »


Dr. Naresh Kumar Monigari

Answer: Hi, Welcome to icliniq.com. The reports suggest that you are probably having an autoimmune disease. For an exact diagnosis, ANA (antinuclear antibody) global or ANA profile test report and skin or muscle biopsy would be required to avoid any controversies in the future. I also need to know the follo...  Read Full »

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