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Bleeding and Clotting Disorders

Elevated IGM and Low RBC, and WBC

03/16/2010

Question:

I have had two SPEP test ordered by my Nephologist to come back elevated within six months of each other. The first was 297 and second 348. Second test stated "possible early monoclonal, sugguest close follow-up, repeat 1-2 months". Had follow-up repeat test, do not have results yet. How high does IGM need to be, to be significant? Or is the fact that it suggested close follow-up and repeat implying significance?

Second I have had low rbc, hemo, and wbc on cbc. Was diagnosed as having iron deficiency anemia. Have had endo and colonoscopy. Hiatal hernia, gastritis, and diverticulosis, as well as been treated for h pylori. I have also had d/c for heavy periods six months ago. Still low cbc. This time however wbc was low for second time within 8 months. Would or could the elevated IGM and low hemo, and wbc be related? I have so many symptoms that could be related to a blood disorder such as MM or WM. I will see a hematologist next week at OSU. What questions might I need to ask him? I`m hoping that he`s one of those good listening, caring Doctor`s. Thank you.

Answer:

While you are asking all the correct questions, it is difficult to give any definite answers in a forum such as this without having a chance to talk with you in person, interview you, and examine you. Your visit with the hematologist should be able to sort out whether this is a monoclonal protein of uncertain significance or a more significant issue such as Waldenstroms or another related condition.

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Response by:

Spero R Cataland, MD Spero R Cataland, MD
Associate Professor of Clinical Internal Medicine
College of Medicine
The Ohio State University