Waldenström's macroglobulinemia history and symptoms: Difference between revisions
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:*Lymphedema | :*Lymphedema | ||
====Hyperviscosity syndrome==== | ====Hyperviscosity syndrome==== | ||
Accumulation of IgM proteins in blood can increase the viscosity of blood, slowing down the flow of blood to different organs. | :*Accumulation of IgM proteins in blood can increase the viscosity of blood, slowing down the flow of blood to different organs. | ||
:*Retinal hemorrhage with blurring of vision | :*Clinical manifestation of hyper viscosity syndrome occur if serum viscosity is >4 centipoises.<ref name="HF">Waldenström's macroglobulinemia. UpToDate (2015)http://www.uptodate.com/contents/epidemiology-pathogenesis-clinical-manifestations-and-diagnosis-of-waldenstrom-macroglobulinemia?source=machineLearning&search=Waldenström%27s+macroglobulinemia&selectedTitle=1%7E80§ionRank=3&anchor=H29#H6 Accessed on November 10, 2015</ref> | ||
Neurological Symptoms of hyperviscosity: | |||
:*Retinal hemorrhage with blurring of vision | |||
:*Vertigo | :*Vertigo | ||
:*Dizziness | :*Dizziness | ||
:*Headache | :*Headache | ||
:*Nystagmus | |||
:*Tinnitus | |||
:*Ataxia | |||
Vascular symptom: | |||
:*Oronasal bleeding | :*Oronasal bleeding | ||
::* | Neuropathic symptoms: | ||
::* | :*Most prominent neuropathic symptom of Waldenström's macroglobulinemia is progressive sensorimotor peripheral neuropathy, mostly of distal lower extremity. | ||
:*Symtoms are associated with Anti-myelin-associated glycoprotein activity. | |||
:*Less common neuropathic manifestations are cranial nerve palsies, mononeuropathy, mononeuritis multiplex, multifocal leukoencephalopathy, and sudden deafness. | |||
Cryoglobulinemia: | |||
:*Serious symptoms of Waldenström's macroglobulinemia include Raynaud phenomenon, urticaria, purpura, acral cyanosis, and/or tissue necrosis. | |||
Renal involvement: | |||
:*In few cases of Waldenström's macroglobulinemia, deposits of IgM in the glomerular basement membrane and infiltration of lymphocytes or plasmacytoid cells occur. | |||
:*Immune-mediated glomerulonephritis, typically due to IgM deposition or cryoglobulinemia | |||
:*Renal amyloidosis can lead to Nephrotic syndrome in few cases. | |||
Gastrointestinal involvement: | |||
:*Deposition of monoclonal IgM protein in the lamina propria of intestine can produce diarrhea/steatorrhea due to malabsorption. | |||
Cutaneous involvement: | |||
:*Infiltration of dermis by Lymphoplasmacytoid cells can produce macular or papulonodular lesions | |||
:*Deposition of IgM on epidermal basement membrane proteins can lead to multiple flesh colored pruritic papule on extensor surface | |||
==References== | ==References== | ||
Revision as of 20:47, 10 November 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mirdula Sharma, MBBS [2]
Overview
History and Symptoms
Asymptomatic or Smoldering:
Presents in 30% of patients with Waldenström's macroglobulinemia.[1]
Symptomatic:
Constitutional symptoms
- Weight loss[1]
- Fever
- Night sweat
- Lymphedema
Hyperviscosity syndrome
- Accumulation of IgM proteins in blood can increase the viscosity of blood, slowing down the flow of blood to different organs.
- Clinical manifestation of hyper viscosity syndrome occur if serum viscosity is >4 centipoises.[2]
Neurological Symptoms of hyperviscosity:
- Retinal hemorrhage with blurring of vision
- Vertigo
- Dizziness
- Headache
- Nystagmus
- Tinnitus
- Ataxia
Vascular symptom:
- Oronasal bleeding
Neuropathic symptoms:
- Most prominent neuropathic symptom of Waldenström's macroglobulinemia is progressive sensorimotor peripheral neuropathy, mostly of distal lower extremity.
- Symtoms are associated with Anti-myelin-associated glycoprotein activity.
- Less common neuropathic manifestations are cranial nerve palsies, mononeuropathy, mononeuritis multiplex, multifocal leukoencephalopathy, and sudden deafness.
Cryoglobulinemia:
- Serious symptoms of Waldenström's macroglobulinemia include Raynaud phenomenon, urticaria, purpura, acral cyanosis, and/or tissue necrosis.
Renal involvement:
- In few cases of Waldenström's macroglobulinemia, deposits of IgM in the glomerular basement membrane and infiltration of lymphocytes or plasmacytoid cells occur.
- Immune-mediated glomerulonephritis, typically due to IgM deposition or cryoglobulinemia
- Renal amyloidosis can lead to Nephrotic syndrome in few cases.
Gastrointestinal involvement:
- Deposition of monoclonal IgM protein in the lamina propria of intestine can produce diarrhea/steatorrhea due to malabsorption.
Cutaneous involvement:
- Infiltration of dermis by Lymphoplasmacytoid cells can produce macular or papulonodular lesions
- Deposition of IgM on epidermal basement membrane proteins can lead to multiple flesh colored pruritic papule on extensor surface
References
- ↑ 1.0 1.1 Waldenström's macroglobulinemia symptoms and signs. Cancer.Net (2015)http://www.cancer.net/cancer-types/waldenstrom’s-macroglobulinemia/symptoms-and-signs Accessed on November 10, 2015
- ↑ Waldenström's macroglobulinemia. UpToDate (2015)http://www.uptodate.com/contents/epidemiology-pathogenesis-clinical-manifestations-and-diagnosis-of-waldenstrom-macroglobulinemia?source=machineLearning&search=Waldenström%27s+macroglobulinemia&selectedTitle=1%7E80§ionRank=3&anchor=H29#H6 Accessed on November 10, 2015