Haem- paraproteinaemias Flashcards
(15 cards)
what is multiple myeloma
plasma cell dyscrasia characterised by abnormal clonal proliferation of post-germinal b cells (plasma cells)- monoclonal
median age of multiple myeloma
elderly- 65 years
risk factors of multiple myeloma
male sex
black African ethnicity
family history
obesity
clinical features of multiple myeloma
bone pain- most commonly backache
weakness
fatigue
anaemia
weight loss
recurrent infections
Rarely, symptoms/signs of hyperviscosity and bleeding due to thrombocytopenia (easy bruising/bleeding etc.)
signs of multiple myeloma
hypercalcaemia
anaemia
renal failure
lytic bone lesions
what is monoclonal gammopathy of undetermined significance (MGUS) defined as-
paraprotein <30g/l
bone marrow plasma cells <10%
no evidence of myeloma end organ damage
what is waldenstrom’s macroglobulinaemia
low-grade lymphoma, igM found in bone marrow and other organ
risk factors for waldenstrom’s macroglobulinaemia
family/personal history of autoimmune, infective, inflammatory diseases
especially- sjogrens syndrome and autoimmune haemolytic anaemia
paraprotein clinical features of waldenstrom’s macroglobulinaemia
hyperviscosity hyperviscosity syndrome- caused by igM being pentameric- confusion, coma, visual disturbances, fatigue, bleeding, cardiac failure
neuropathy
what is the best investigation to diagnose multiple myeloma
serum electrophoresis
what is the 1st line chemotherapy combination used in multiple myeloma
MPT combo
melphalan, prednisone, thalidomide
- thalidomide, alkylating agent, corticosteroid
what is the name of the characteristic protein found in urine of patients with multiple myeloma
bence jones protein
is multiple myeloma associated with an increase/decrease in serum free light chains
increase
in multiple myeloma, there are more than what percentage of plasma cells
10%
symptoms of multiple myeloma CRAB
calcium raised
renal failure
anaemia
bone lesions
