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Twiching, cramping, tingling in extremities with normal MRI, EMG.

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Hi. I am a 31 year old female and have been having some troubling symptoms for almost a year and a half.
November 2013- Tingling in extremities and face
Late October 2014- Weak feeling in arms, twitching, cramping
I have seen an neurologist and have had a normal exam. He says no MS (MRI of brain and spine was clear) and no ALS (EMG was clear.) Have had lyme, vitamin, and thyroid testing done.- all clear. Band 23 keeps coming up on my lyme testing though. However my additional bloodwork just came back from the neuro and it is still some time before I see him again. I was wondering if you could shed some light on what these results might mean. Thanks so much!

Immunofixation Result, Serum----> An apparent polyclonal gammopathy: IgM. Kappa and lambda typing appear increased.

Immunoglobulin G, Qn, Serum-----> 932 reference range 700-1600
Immunoglobulin A, Qn, Serum------> 97 reference range 91-414
Immunoglobulin M, Qn, Serum------>339 refence range 40-230

Creatine and Thyroid Peroxidase were in normal ranges. (61, 10)

Is this test suggestive for blood cancer? (What my internet searches have been yielding.)

Thanks so much!!!

Category: Neurologist, Medical

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Dr. Sudhir Kumar
Category: Pediatric Neurologist
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 26 Doctors Online


Patient replied :

IT also stated that "An apparent polyclonal gammopathy: IgM. Kappa and lambda typing appear increased. "- what does this mean?
Thanks so much.


Expert:  Dr. Sudhir Kumar
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Hello,
Thank you for your query at DoctorSpring.com
I understand your concern and sincerely apologize for the delay in reply.
The symptoms you had are suggestive of a vitamin deficiency. You need to get your vitamin b12 levels evaluated.
Now regarding the IGM kappa lambda typing levels, these are precursors of multiple myeloma, a form of blood cancer. It is important you get a serum electrophoresis done, to check for monoclonal proteins in the serum. This is very important to establish the diagnosis.
I will advise you to meet a hematologist and follow-up with the electrophoresis reports.
Please feel free to discuss further,
Dr. Sudhir Kumar
DM Neurology


Patient replied :

Hello, I met with a hematologist today after speaking with my primary care physician- she said it was just to be on the safe side. Hematologist said absolutely no cancer because no monoclonal gamathopothy. He tested my hemmoglobin which was fine. He said he is doing a workup just to be on the safe side but feels very strongly there is no cancer here. He didn't say anything about the kapp and lambda typing levels (He did see the report.) Would he had told me if I had a precursor to blood cancer? He made it seems as if he really thought I am in the clear. I have a follow up with him in 10 days. Can you have kappa and lamdda typing levels elevated and everything skill be okay?

THanks so much.


Expert:  Dr. Sudhir Kumar
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Hello,
Thank you for the follow-up.
That is indeed a great news, that your hematologist thinks there are no evidences of cancer.
Yes, not all kappa lambda elevations point towards cancer, more specifically Multiple Myeloma.
You can still discuss and opt for serum electrophoresis, to be absolutely sure.
Hope this was helpful,
Regards.

Dr. Sudhir Kumar
Category: Pediatric Neurologist
Experience: 
Senior Residency, Fellowship: DM, Neurology, CMC, Vellore, 2001
Junior Residency: MD, Internal Medicine, CMC, Vellore, 1998
Medical School: MBBS, Christian Medical College, Vellore, 1995
Dr. Sudhir Kumar and 4 other Medical Specialists are ready to help you

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