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Oncology (General Cancer)/Serum and urine immunofixation

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Question
Dr. Minur,
Thank you so much for your time.  I recently was sent to a neurologist due to vertigo and some other issues.  The dr. Did a full neuro exam and said due to certain reflexes in my feet and elsewhere it appears i have an issue in the brain or upper spine.  I also had a markedly abnormal eye response.  Dyploplia,  that came on instantly following a severe headache.   I have a pacemaker, so i can't have an MRI.   I do take Coumadin as i have several stroke risk factors, including Afib.  I have been on Coumadin for 14 yrs.  i am a 44 yr old woman.

Well, moving on because my young daughter has rheumatoid arthritis and autoimmune hepatitis, my dr decided to run a variety of blood tests.   My blood work came back with a positive rheumatoid factor and also high serum protein immunofixation.  She is having that repeated as well as a urine immunofixation test.

Could you help me understand what these tests are looking for and how any of this could be connected. Anything you have to offer will be greatly appreciated.
Thank you!
Chris

Answer
Hi,
My name is Munir no Minur.
In case of your problem, I think the presence of a peripheral neuropathy should be confirmed with examination and EMG testing. Then the associated conditions should be ruled out by complete blood cell count (CBC), chemistry panel with serum glucose, Hgb A1c, TSH, B12, folate, erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA), rheumatoid factor (RF), serum protein electropheresis (SPEP), immuno-fixation (IFE), hepatitis panel, and any other specific blood tests that are suggested by the medical history or exam.

If abnormalities are found, further medical evaluation as well as treatment should be initiated and observation for improvement or stabilization of symptoms should occur for the next few months.

If there is a family history of peripheral neuropathy, or an undiagnosed disorder of abnormal appearing feet or gait, a hereditary neuropathy is suggested. A carefully obtained pedigree to determine the pattern of inheritance as autosomal dominant, recessive or X-linked, in combination with the electrophysiologic type of neuropathy and associated features has been traditionally used to classify the type of hereditary neuropathy. Advances in molecular diagnostic testing have made the definitive diagnosis of a growing list of specific genetic neuropathies possible. However, because inherited peripheral neuropathies have no specific therapy at present, the clinical value of knowing the exact cause of a neuropathy may not be clear and the cost of a full screening evaluation may be expensive. In most cases, however, a focused laboratory examination for the genetic causes of neuropathy can directly affect the present and future treatment of the patient and may have important implications for prognostic counseling. Even if no family history is obtained, testing in sporadic cases may be clinically more useful than in those cases with a strong family history, since those with a treatable acquired neuropathy in which further testing should be pursued, can be separated from those in which an untreatable genetic neuropathy has been identified.

Oncology (General Cancer)

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Dr M Khalid Munir

Expertise

I can answer questions about the correct guideline for treatment of cancers to achieve best results. I can analyze signs and symptoms to identify cancer. I can tell about many good treatment methods recognized by American Cancer Society and NIH which have been developed recently through credible cancer research.

Experience

I have been working as a Immuno Oncologist since the last five years. I have experience of treating cancer patients through a variety of methods. My patients have been treated with radiation therapy, chemotherapy and surgery. I am also trained in Antiangiogenic therapy, Immunomodulator therapy and Immunotherapy of cancer which is a FDA recognized treatment method and also a known effective modern therapy as per the guidelines of the American Cancer Society (ww.cancer.org). Immunotherapy works by enhancing the body's own defence mechanism hundreds of times. It is used to treat Hepattis and AIDS too.

Organizations
2. Consultant Immuno Oncologist, Wockhardt Hospital, Hyderabad, India. An associate of Harvard medical international. 3. Ex Care management consultant, Royal Hobart Hospital, Australia. 4. Ex Care management consultant, KGH, Canada. 5. Associate, IAMMS, Aligarh, India (A UNESCO listed organisation).

Education/Credentials
Medical Doctor with MBBS and Fellowship in Immuno oncology. 2. Fellowship in Dendritic cell therapy from ICT, Noida, New Delhi NCR 3. Member of American Geriatrics Society 4. Having specialised Training in a. Dendritic cell therapy and Chemotherapy b. Hematology c. AIDS prevention d. Geriatric medicine

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