Q. Can paraproteins fluctuate without treatment?
Hello doctor,
Can paraproteins fluctuate (drop) without treatment?
Hi,
Welcome to icliniq.com. We are here to help you. Yes, the levels can vary. In fact the levels always fluctuate and hence never used as a marker of treatment response.
Hello doctor,
It has dropped from 5.8739 g/dL to 4.8739 g/dL in six months, whereas before it was always in the 50s range. Would it drop by such a large margin? Should I start the treatment now? What treatment has to be followed?
Hi,
Welcome back to icliniq.com. Yes, this drop can happen and to comment on the treatment warranted, I need to see your serum protein electrophoresis report to see which gammopathy you are having. I also need to know your hemoglobin as well as kidney function tests. Kindly mention why treatment has not been started yet.
Hello doctor,
My test results are this way IgA - 16.6 mg/dL, IgM - 33.5 mg/dL, IgG - 4873.8 mg/dL, B2 microglobulin - 1.4 mcg/mL, hemoglobin - 10.1 g/dL, RBC - 3.48 million cells per microliter, WBC - 3.57 million cells per microliter and hematocrit (Hct) - 29.9 %. Renal profile is all within range except for sodium a little under the lower limit. I just got my diagnosis 20 days back. I am about to discuss treatment with the hematologist tomorrow. Please guide.
Hi,
Welcome back to icliniq.com. I have checked your test results that you have mentioned. Elevation in immunoglobulin G (IgG) can occur due to chronic infections like hepatitis B, C and human immunodeficiency virus (HIV). Also, it can occur in monoclonal gammopathies such as multiple myeloma, amyloidosis and monoclonal gammopathy of undetermined significance. You would be further evaluated by various other tests by your doctor. If the diagnosis gets supported for multiple myeloma then you would need treatment for that. Otherwise, you will be evaluated for other infections and treated accordingly.
Hi doctor,
I was diagnosed with multiple myeloma because of the presence and level of the monoclonal protein and two lytic lesions and also a kappa/lambda ratio of 0.19 using the nephelometric immunoassay latex enhanced method. I just need a second opinion to the diagnosis. When compared to the start of treatment, now I am a bit confused as to why the paraprotein was fluctuating.
Hi,
Welcome back to icliniq.com. In that case, you should be started on treatment for multiple myeloma. Fluctuations can be there, but treatment needs to be initiated.
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