Waldenström's macroglobulinemia laboratory findings: Difference between revisions
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**Normocytic normochromic red blood cells | **Normocytic normochromic red blood cells | ||
**[[Rouleaux]] formation | **[[Rouleaux]] formation | ||
* '''Chemistry Lab tests:''' | |||
**Elevated [[lactate dehydrogenase]] (LDH) | |||
***Level indicates the extent of the disease | |||
* '''Chemistry Lab tests''' | |||
**Elevated [[ | |||
** | |||
**Elevated [[creatinine]] | **Elevated [[creatinine]] | ||
***Rarely | |||
**Electrolyte abnormalities: | **Electrolyte abnormalities: | ||
***[[Hypercalcemia]] | ***[[Hypercalcemia]] | ||
**Elevated [[erythrocyte sedimentation rate]] and [[uric acid | ***Hyponatremia | ||
**Elevated [[erythrocyte sedimentation rate]] (ESR) and [[uric acid]] | |||
**[[Rheumatoid factor]], [[cryoglobulins]], direct anti-globulin test, and cold agglutinin titre results can be positive | |||
**[[Rheumatoid factor]], [[cryoglobulins]], direct anti-globulin test, and cold agglutinin titre results can be positive | **Elevated [[beta-2-microglobulin]] in proportion to tumor mass | ||
**[[ | *** Needed to evaluate prognosis | ||
* '''Platelet function test and blood coagulation studies:''' | |||
** Prolonged bleeding time | |||
*** Possibly due to interaction between platelet surface glycoproteins and IgM paraprotein | |||
** Abnormalities in prothrombin time, activated partial thromboplastin time, thrombin time, and fibrinogen | |||
* '''Plasma viscosity''' | * '''Plasma viscosity''' | ||
**Plasma viscosity should be measured in patients presenting with [[hyperviscosity syndrome]] whenever the monoclonal IgM protein spike is >4 g/dL. | **Plasma viscosity should be measured in patients presenting with [[hyperviscosity syndrome]] whenever the monoclonal IgM protein spike is >4 g/dL. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Roukoz A. Karam, M.D.[2] Mirdula Sharma, MBBS [3]
Overview
Laboratory findings consistent with the diagnosis of Waldenström's macroglobulinemia include any cytopenia, elevated LDH, and elevated Beta-2 microglobulin.
Laboratory Findings
Laboratory findings consistent with the diagnosis of Waldenström macroglobulinemia include:[1]
- Complete blood count:
- Anemia
- Seen in 40% of newly diagnosed patients and in 80% of symptomatic patients with Waldenström's macroglobulinemia
- Multifactorial causes including: decreased RBC synthesis due to bone marrow infiltration, iron deficiency due to gastrointestinal bleeding, chronic inflammation.
- Thrombocytopenia
- Due to bone marrow infiltration
- Due to bone marrow infiltration
- Neutropenia
- Due to bone marrow infiltration
- Lymphocytosis
- Monocytosis
- Anemia
- Peripheral smear:
- Plasmacytoid lymphocytes
- Normocytic normochromic red blood cells
- Rouleaux formation
- Chemistry Lab tests:
- Elevated lactate dehydrogenase (LDH)
- Level indicates the extent of the disease
- Elevated creatinine
- Rarely
- Electrolyte abnormalities:
- Hypercalcemia
- Hyponatremia
- Elevated erythrocyte sedimentation rate (ESR) and uric acid
- Rheumatoid factor, cryoglobulins, direct anti-globulin test, and cold agglutinin titre results can be positive
- Elevated beta-2-microglobulin in proportion to tumor mass
- Needed to evaluate prognosis
- Elevated lactate dehydrogenase (LDH)
- Platelet function test and blood coagulation studies:
- Prolonged bleeding time
- Possibly due to interaction between platelet surface glycoproteins and IgM paraprotein
- Abnormalities in prothrombin time, activated partial thromboplastin time, thrombin time, and fibrinogen
- Prolonged bleeding time
- Plasma viscosity
- Plasma viscosity should be measured in patients presenting with hyperviscosity syndrome whenever the monoclonal IgM protein spike is >4 g/dL.
- The normal plasma viscosity is 1.8 centipoise.
- Patient presents with hyperviscosity symptoms with viscosity >4 centipoise.
References
- ↑ García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A; et al. (2001). "Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases". Br J Haematol. 115 (3): 575–82. PMID 11736938.