Protein synthesis with electrofusion

My symptoms are fatigue, back pain, ear ringing.  Had every test known to mankind.  All negative except the protein synthesis with electrofusion,  they are doing a bone marrow check in weds.  Everything else was fine..  Full blood and smear done.  Any ideas?  Feel like rap all the time.  Terrible back pain, ear ringing.

Thanks

[Hien K Duong, MD]

Brucergoldberg,

I apologize for my delayed response.  I think that you are referring to a study called protein electropheresis?  It is a blood (or urine) test that is often used to analyze proteins.  

Specifically, we use this test to look for abnormal proteins that may be present in your blood or urine. This test helps to characterize the type of abnormal protein that is present and further studies may be necessary to determine the amount of abnormal protein that is present.  The abnormal protein is referred to as monoclonal gammopathy or monoclonal paraproteinemia. The term monoclonal refers to the presence of these proteins as being derived from a single clone of abnormal cells, more suggestive of a malignant process.

If only low levels of abnormal protein are present and there is no evidence of other systemic or organ disease, this would be considered monoclonal gammopathy of undetermined significance (MGUS).  If the levels are higher and there is evidence of systemic disease, including abnormal cells in your bone marrow, the concern is that this could be multiple myeloma, a type of cancer of a white blood cell called the plasma cell.

is possible that you have a monoclonal gammopathy, thus warranting the bone marrow biopsy.  You should follow up closely with your physician.

Because these abnormal proteins can also cause problems in your bones, given that you have back pain already, it may be necessary to obtain x-rays of your back and/or other bones (skeletal survey).

I am not sure about the cause of your ear-ringing. Are you taking other medications for the back pain? You should discuss further with your physician, who can take a complete history and help to determine the possible cause.

Hope that this helps.  Feel free to post comments here if you should have further questions.  Thank you.

[Brucergoldberg]

Hien

My levels were high, however when the CBC was done plus everything else, it all appeared be negative.  She doesn't understand why the spep was positive but all other blood was fine....

[Brucergoldberg]

Also she is going to do a peda scan on me as well.   Could hashimotos be causing these results?   Thank you.

[Hien K Duong, MD]

Brucergoldberg,

It's difficult for me to be able to help you with the diagnosis, without having comprehensive information.  It is likely going to be more helpful to discuss these questions further with your hematologist or to be evaluated by another physician for a second opinion.  

If the SPEP was positive for detectable monoclonal protein, it is usually followed up with monoclonal protein immunofixation studies (serum and urine) in order to characterize the type of monoclonal protein.  If these are negative, there are other studies that might still be helpful.  Also, the bone marrow biopsy results will be especially important in this setting.

The presence of monoclonal protein has reportedly been associated with a wide variety of disorders, including Hashimoto's thyroiditis. However, there really is no clear relationship or association between these two conditions.  

[Brucergoldberg]

Hey dr.  Thanks for the reply.  My dr.s. Dr. Ngyugen and Dr. le did the bone marrow scan and it came back negative.  They think it's from the hashimotos.  What a horrible disease. They think my body is throwing out antibodies thatbthrew the protein test off.  I still feel junky, but glad it's not cancer.  I laugh with them by the way that ball the best hematologists are Vietnamese!

bruce

[Hien K Duong, MD]

Brucergoldberg,

How interesting that your physicians have all been Vietnamese!  I am sorry to hear about the Hashimoto's disease.  I hope that things improve for you and that you start to feel better soon!

Good luck and take care!