Hyper IgM level, Elevated Gamma Globulin.

[Ravi2012]

Hi, I am a 30 yrs old man. I got exposed to toxic chemical fumes (possible carcinogens) for 30min ~ 4 months ago. I developed (a) frontal headache in every morning and (b) pain on the right rib side in the lower half of the rib. Rib pain is mild and no improvement in 4 months. Morning headache improved after having amoxicilline for 10days but I still have mild pain in the forehead and temple area everyday. (c) Recently I started having numbness feeling in my right hand fingers. (d) Have had few drops of blood in the dry nasal mucus from right nostril few times, or trace of blood when I blow my nose sometimes.

Abnormal Blood work: High Igm (497 (Lab max. 230)), Elevated Gamma Globulin (1.7 (Lab max. 1.6) measured on Feb1, and 1.47 (Lab max. 1.33) measured on Feb11).  Increased polyclonal immunoglobulins.
kappa appears increased (2.41 (Lab max. 1.94)), but lambda is w/in the range (1.94 (Lab max. 2.63), and kappa/ lambda is w/in range (1.24, (Lab max. 1.65)).

Normal Blood work: CBC, CMP, ESR, CRP, CK, Vit D, Vat B12,Diabetese, Hep. A/B/C, Complement 3 &4, Rhematoid factor, ANA, LACTATE DEHYDROGENASE, DNA AUTOABS DOUBLE STRANDED, SCLERODERMA ANTIBODY SCL 70, ENA ANTIBODIES (SM AND SM/RNP). All came normal

Eco, Lungs CT angio, Head CT and Head MRI, Rib Xray. They all came normal.

My immunologist was suspecting myloma as I am complaing rib wall pain, but my immunofixation result is polyclonal. He couldn't find anything wrong w/ liver or any auto-immune diseases to attribute my symptoms (Headache, rib-pain and the numbness feeling in my hand fingers). I am afraid if I may still have myloma, or is there any other infection/disease that can explain my symptoms? Any suggestion for any test, or what could be wrong w/ me would be heartly appreciated? I was very healthy since last 8 years and never had any health issues until this chemical inhalation. Thanks very much.

[Ravi2012]

Thanks madam for your response. My Hep. A/B/C test came negative but I do feel discomfort under the lower right lobe of my rib. It makes me feel that something is wrong. I recently had my bone scan done and it showed an 'abnormality at my 7th posterior rib'. Doc discarded that saying it may be due to any traumatic injury, but I never had any injury before and I am only 30, no artheritis. I am afraid he is overlooking something serious. I requested to order MRI to find the nature of abnormality but he didn't. I am scared if I have any serious blood/bone disease as I am having pain in the rib wall and headache both for last4 months.

[karajo]

I too have right rib pain and every docotr seems to have their own spin on what is might be.  I also have fibromyalgia and possible (probable) lupus.  But in my research I came across something that might help you pin it down.  Google "Costochondritis".  Don't know if that might be what is going on.  

I was hoping Dr Kokli might help you on the lab results.  At a glance (and totally just an educated assessment) you lab work truly indicates an autoimmune response or a chronic infection.  Is there any chance that you might have hepetits?  The term basically means inflammed liver.  And can be caused by certain medicines, or fatty liver, etc.