Waldenström's macroglobulinemia laboratory findings: Difference between revisions
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{{CMG}} {{AE}} {{MGS}} | {{CMG}} {{AE}} {{MGS}} | ||
==Overview== | ==Overview== | ||
Elevated Beta-2-microglobulin and abnormal coagulation studies are diagnostic of Waldenström's macroglobulinemia. <ref name="LAB">Waldenström's macroglobulinemia. Medscape (2015)http://emedicine.medscape.com/article/207097-workup#c7 Accessed on November 10, 2015</ref> | |||
==Laboratory Findings== | ==Laboratory Findings== | ||
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====Chemistry lab tests==== | ====Chemistry lab tests==== | ||
*Beta-2-microglobulin is elevated in proportion to tumor mass. | |||
*Lactate dehydrogenase - is elevated indicating the extent of tissue involvement. | *Lactate dehydrogenase - is elevated indicating the extent of tissue involvement. | ||
*Creatinine is elevated. | *Creatinine is elevated. | ||
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*Albumin-to-globulin ratio | *Albumin-to-globulin ratio | ||
*Rheumatoid factor, cryoglobulins, direct antiglobulin test and cold agglutinin titre results can be positive. | *Rheumatoid factor, cryoglobulins, direct antiglobulin test and cold agglutinin titre results can be positive. | ||
*Coaglulation studies can be abnormal with elevated prothrombin time, activated partial thromboplastin time, and thrombin time. | *Coaglulation studies can be abnormal with elevated prothrombin time, activated partial thromboplastin time, and thrombin time. | ||
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References: | '''References:''' | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 16:16, 13 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
Elevated Beta-2-microglobulin and abnormal coagulation studies are diagnostic of Waldenström's macroglobulinemia. [1]
Laboratory Findings
Complete blood count
- Normocytic normochromic anemia - presents in 80% of patients[1]
- Leukopenia
- Thrombocytopenia - presents in 50% of patients with bleeding diathesis
Peripheral smear
- Plasmacytoid lymphocytes
- Normocytic normochromic red blood cells
- Rouleaux formation
Chemistry lab tests
- Beta-2-microglobulin is elevated in proportion to tumor mass.
- Lactate dehydrogenase - is elevated indicating the extent of tissue involvement.
- Creatinine is elevated.
- Electrolyte abnormalities can be present with hypercalcemia in 4% of patients with Waldenström's macroglobulinemia.
- Erythrocyte Sedimentation Rate and uric acid may be elevated.
- Renal and hepatic function
- Total protein levels
- Albumin-to-globulin ratio
- Rheumatoid factor, cryoglobulins, direct antiglobulin test and cold agglutinin titre results can be positive.
- Coaglulation studies can be abnormal with elevated prothrombin time, activated partial thromboplastin time, and thrombin time.
Plasma viscosity
- The normal Plasma viscosity is 1.8 centipoise. Patients start presenting with hyperviscosity symptoms when viscosity >4 centipoise.[2]
- Plasma viscosity should be measured in patients presenting with hyper viscosity syndrome whenever the monoclonal IgM protein spike is >4 g/dL.
References:
- ↑ 1.0 1.1 Waldenström's macroglobulinemia. Medscape (2015)http://emedicine.medscape.com/article/207097-workup#c7 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#H18 Accessed on November 10, 2015