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Q. Can increasing hip and abdominal pain and abnormal blood reports indicate any severe conditions like multiple myeloma?

Answered by
Dr. Parth R Goswami
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 25, 2022

Hi doctor,

I have been experiencing symptoms like nausea and vomiting over the past year, and it has been progressively getting more frequent. I have had persistent, sometimes debilitating, pain in my hip area for the last few months. X-ray and scans so far have revealed nothing. I am often very fatigued and have pain in my abdomen. Based on the tests that have been prescribed to me, it seems as though they may be looking for multiple myeloma. My current medications are- tablet Hydrochlorothiazide 25 mg, tablet Nebivolol 10 mg, tablet Amlodipine 5 mg, and tablet Estradiol 2 mg. I have been getting blood and urine tests ordered by my PCP and now a hematologist due to the symptoms, which have been steadily increasing over the past year. The out of range values from the latest test are as follows-

ALT- 68 u/l

AST- 53 u/l

Beta 2 globulin- 0.8 g/dL

Immunoglubulin A- 906 mg/dL

Kappa light chain, free, serum- 44.6 mg/L

Lambda light chain, free, serum- 33.6 mg/L

White blood cell count - 11 thousand per uL of blood.

And in case it matters - IFE interpretation- Normal pattern. No monoclonal proteins were detected. Even though my results are in, the doctor will not be going over them for another week or two. Based on an internet search, it seems like they may be looking for multiple myeloma, but I am just trying to get some kind of indication of what I may have? I am looking for a second opinion from you. Thanks.

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Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Following is my opinion for your reports and asked questions-

1. IgA and protein values are increased, but electrophoresis is normal. So, some form of inflammation might be responsible for elevation that increased protein. However, you are right. Plasma cell dyscrasia like multiple myeloma needs to be ruled out by immunofixation serum protein electrophoresis to ensure that nothing is abnormal. So, I suggest you investigate further with immunofixation electrophoresis (IFE).

2. Your kappa lambda ratio is normal. So, there is less chance of plasma cell dyscrasia, but the investigation will help in diagnosis.

3. SGPT (serum glutamate-pyruvate transaminase) was elevated twofold. Hence problems like fatty liver might be responsible for that. So I suggest you investigate further with an ultrasound abdomen for elevated SGPT.

I hope I have answered all your questions.

Let me know if I can assist you further.

Best regards.


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