Question 1

my kappa- lambda ratio 2.2, is that high?

Accepted Answer

Somewhat: That ratio is elevated and may represent some problem with your kidneys or your blood elements. The results need to be evaluated along with a protein electrophoresis test of your blood for more solid information. Contact whoever ordered the test and ask what they feel it represents and what further testing you may need, especially if you know your kidney function is normal.

Question 2

is elevated kappa/lambda ratio on serum flc test inherently monoclonal, even if neither kappa or lambda is elevated? ratio high b/c lambda is low, not because of high kappa. spep/upep & ife normal. high iga, low igg. clean marrow biopsy. polyclonal?

Accepted Answer

FLC not useful: FLC and kappa/lambda ratio are not useful tests. A normal K/L ratio does not exclude monoclonal gammopathy and an abnormal one is not diagnostic of one. From what you described you do not have monoclonal gammopathy and certainly have no multiple myeloma.

Question 3

is a free light chain kappa/lambda ratio of 13 relatively high or just a touch high, with abnormal monoclonal protein anti igg and anti lambda? under medical care. just curious before follow up. not expecting diagnosis. positive ana 1:320 homogeneous?

Accepted Answer

: That number is higher than expected.

https://my.clevelandclinic.org/health/diagnostics/22369-kappa-free-light-chain-test

https://pubmed.ncbi.nlm.nih.gov/26038841/

Your ANA is  high as well,  Would check for kidney disease, lupus/ autoimmune disease and myeloma.

Question 4

this is for my mother, aged 55. high serum kappas (33), normal lambdas and marginally high kappa lambda ratio (1.9). spep and immunofixation show polyclonal gammopathy (in igg kappa and lambda). should we be concerned about mgus/myeloma ?

Accepted Answer

: No need for concern. More than 30% of people your mother's age have a marginally abnormal kappa lambda ratio with excess kappa. More than 50% of the people with polyclonal gammopathy have a kappa dominant kappa lambda ratio without having MGUS or myeloma.
For info: J Appl Lab Med
. 2020 Nov 1;5(6):1358-1371. doi: 10.1093/jalm/jfaa153.

Question 5

will drinking a lot of water each day (96+oz) decrease kappa light chain levels? electrophoresis normal with the exception of slightly elevated kappa in serum of 21.8 (normal in urine). normal kappa lambda ratio?

Accepted Answer

No: Drinking more water would not decrease isolated kappa light chain levels. All tests should be interpreted in clinical context and if believed to be slightly dehydrated at the time of test, based on other tests, such as renal function tests keeping optimal hydration might help in all departments. Your ordering doc would be your best reference at this point as having the full picture.

Question 6

i have small fiber neuropathy diagnosed by skin biopsy. my kappa free light chain was slightly elevated with normal lambda and normal kappa/lambda ratio. is it possible i have amyloidosis?

Accepted Answer

: NO, there is no proof of amyloidosis so far, and there seems to be no amyloid deposition noted on the biopsy.  The kappa/ lambda data is also non-diagnostic.  The most frequent cause of isolated small fiber neuropathy in the USA is pre-diabetes and diabetes.  There are several other causes.  Has your physician discussed possible next steps?  Do you need a second opinion?

Question 7

how much increase in kappa lambda ratio wud mean worrisome?

Accepted Answer

Kappa/lambda: Hi, the normal Kappa/lambda is approximately 0.26 to 1.65. this ratio has to be interpreted along with Serum electrophoresis and also the free light chain values (kappa and lambda), if the free chain is elevated and the ratio is elevated then that could be due to plasma cell disorders like multiple Myeloma or Primary Amyloidosis if the symptoms present. Having said that it's not easy to draw

Question 8

i have 549iga, 37 sedimentation rate westergren, 21.64 free kappa lt chains,s, and kappa/lambda ratio,s is 1.66 what does this mean?

Accepted Answer

Any symptoms?: All laboratory results need to be interpreted in the clinical context and the doctor who ordered the tests is usually in the best position to do that. Having said that,  Why were these tests done? Do you have any symptoms? Kappa/lambda ratio is generally a useless test. IgA of 549, per se is not a problem. Sed rate is in the normal range. 
For good health - Have a diet rich in fresh vegetables, fruits, whole grains, milk and milk products, nuts, beans, legumes, lentils and small amounts of lean meats. Avoid saturated fats. Drink enough water daily, so that your urine is mostly colorless. Exercise at least 150 minutes/week and increase the intensity of exercise gradually. Do not use tobacco, alcohol, weed or street drugs in any form. 
Practice safe sex.

Question 9

kappa lambda ratio u 1.92(l) free kappa lt chains ur 32.10 (h) free lambda lt chains ur 16.70 (h)  24 hour urine  what does this mean?

Accepted Answer

Nothing: In isolation, these mean nothing at all. If only one of the chains is being excreted, I'd worry about plasma cell myeloma. If you're leaking protein in your urine because of your diabetes, this is more concerning than light chain ratios.

Question 10

i've just found out that 3 tests show low kappa/lambda ratio, with lambda light chain levels increased. do these results mean a thing without m protein?

Accepted Answer

Check with your doc: Kappa and lambda are parts of immunoglobulins which are proteins certain white blood cells make to fight infections. These are referred to as polyclonal since they come from different cells.  Some blood disorders can produce lots of m (monoclonal) kappas or lambdas that come from a single, usually malignant cell. Ask your doctor who ordered the lab test to help interpret your specific results.

Get Virtual Care

For Businesses

About Us

HealthTap Online Primary Care Doctors Accepting New Patients

Doctor answers about:

Kappa lambda ratio slightly high

A member asked:

My kappa- lambda ratio 2.2, is that high?

A member asked:

Is elevated kappa/lambda ratio on serum flc test inherently monoclonal, even if neither kappa or lambda is elevated? ratio high b/c lambda is low, not because of high kappa. spep/upep & ife normal. high iga, low igg. clean marrow biopsy. polyclonal?

A member asked:

Is a free light chain kappa/lambda ratio of 13 relatively high or just a touch high, with abnormal monoclonal protein anti igg and anti lambda? under medical care. just curious before follow up. not expecting diagnosis. positive ana 1:320 homogeneous?

A member asked:

This is for my mother, aged 55. high serum kappas (33), normal lambdas and marginally high kappa lambda ratio (1.9). spep and immunofixation show polyclonal gammopathy (in igg kappa and lambda). should we be concerned about mgus/myeloma ?

A member asked:

Will drinking a lot of water each day (96+oz) decrease kappa light chain levels? electrophoresis normal with the exception of slightly elevated kappa in serum of 21.8 (normal in urine). normal kappa lambda ratio?

A member asked:

I have small fiber neuropathy diagnosed by skin biopsy. my kappa free light chain was slightly elevated with normal lambda and normal kappa/lambda ratio. is it possible i have amyloidosis?

A member asked:

How much increase in kappa lambda ratio wud mean worrisome?

A member asked:

I have 549iga, 37 sedimentation rate westergren, 21.64 free kappa lt chains,s, and kappa/lambda ratio,s is 1.66 what does this mean?

A member asked:

Kappa lambda ratio u 1.92(l) free kappa lt chains ur 32.10 (h) free lambda lt chains ur 16.70 (h) 24 hour urine what does this mean?

A member asked:

I've just found out that 3 tests show low kappa/lambda ratio, with lambda light chain levels increased. do these results mean a thing without m protein?

HealthTap Online Primary Care Doctors Accepting New Patients

Telemedicine

Primary Care

Manage Your Conditions

Women's Health

Children's Health

Men's Health

Senior Health

Wellness, Prevention & Lifestyle

Sexual Health

Mental & Behavioral Health

Travel Medicine

Urgent Care

Didn't find what you're looking for?

More of what we treat

Allergies

Antibiotics

Asthma

High Blood Pressure

Prescriptions

Type 2 Diabetes

For Businesses

Company

Health Content

Join Us

Download HealthTap

Questions?