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I have recent onset anemia for which my doctor has

Patient: I have recent onset anemia for which my doctor has ordered a spate of follow up labs. My mother has a history of lymphoma with paraproteinemia, so I worry about blood cancers. My question is whether there is anything in the results so far that suggests I should consult a hematologist.My only concern is that although my serum kappa FLC and lambda FLC were within reference ranges, the kappa-lambda ratio is very slightly high at 1.69 (upper limit of reference range is 1.65). IgG, IgA, and IgM were normal, as was total protein and albumin. No protein in my urine. Urinalysis entirely normal. Also, no other abnormal results other than the data I list or provide in the uploaded image; specifically, kidney and liver function are normal.Other data are as follows:Ferritin = 7Iron = 65TIBC = 366Other data per uploaded lab results.

 

 

Symptoms: No symptoms except constipation. I feel well and have good exercise tolerance.

 

 

Images:
I have recent onset anemia ...-1

Doctor: Hi.Thanks for your query.Read and understood your concerns.Noted your history of healthy except for recent onset a nemia, no symptoms except constipation and have good exercise tolerance. Mother had lymphoma with paraproteinemia, hence worry about cancer.Your reports that you have written:Ferritin is below normal.Iron is just above the lower limit of the normal range.TIBC is within normal limits.kappa-lambda ratio is very slightly high at 1.69 (upper limit of reference range is 1.65).These investigations indicate for consultation with a Hematologist for proper clinical evaluation, examination and further tests to decide the proper diagnosis and plan a proper treatmentThe lab report upload is not seen, please post again.Please tell about constipation to your hematologist so that he can choose the right Iron component that does not increase constipation.Pomegranate is the best iron source in natural food.Equally important is to see for any cause that has caused anemia.I hope this answers your query and helps you further decision making.Take care.

Comments / Follow Ups

Patient: Thanks for your response. Does the kappa-lambda ratio in and of itself suggest any concern? I am uploading the file again.

Patient: Not sure if the file uploaded. I am going to try copying and pasting:
Test Name
Result
Units
Reference Range
Absolute NRBC
0.00
K/uL
0
HCT
33.3
%
36.0-46.0
HGB
10.4
g/dL
12.0-16.0
MCH
25.2
pg
26.0-34.0
MCHC
31.2
g/dL
31.0-37.0
MCV
80.6
fL
80.0-100.0
MPV
10.3
fl
8.4-12.0
NRBC
0.00
/100 WBCs
0
PLT
418
K/uL
150-400
RBC
4.13
M/uL
4.00-5.20
RDW
16.3
%
11.5-14.5
WBC
5.42
K/uL
4.5-11.0

Doctor: Test Name
Result Units Reference Range
Absolute NRBC 0.00 K/uL 0
HCT 33.3% 36.0-46.0
HGB 10.4 g/dL 12.0-16.0
MCH 25.2 pg 26.0-34.0
MCHC 31.2 g/dL 31.0-37.0
MCV 80.6 fL 80.0-100.0
MPV 10.3fl 8.4-12.0
NRBC 0.00 /100 WBCs 0
PLT 418 K/uL 150-400
RBC 4.13 M/uL 4.00-5.20
RDW 16.3% 11.5-14.5
WBC 5.42 K/uL 4.5-11.0
HGB 10.4 g/dL 12.0-16.0 is reduced.
The other reports on borderline are basically calculations related to HGB and hence can appear the way they are.
RBC and WBC counts are normal.
This seems to be iron deficiency anemia.
kappa-lambda ratio is not a routine screening test, is more useful for prognosis of the diagnosed case of plasma cell disorders and best taken into consideration along with other reports and hence to be of concerned after consultation of a Hematologist.
I can understand your concerns due to family history of lymphoma.
Hence it is better to keep these correlations be done by the Hematologist after further clinical evaluation, examination and further tests.
I hope, this answer helps you.

 


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Dr. Suneel Sharman M.D.

Dr. Suneel Sharman M.D.

Dr. Suneel Sharman completed his residency in Family Medicine at the University of Toronto. He currently operates Infinity Health Centre, a walk-in-clinic in downtown Toronto.

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