Lymphoplasmacytic lymphoma other diagnostic studies: Difference between revisions
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***Should be measured in patients presenting with signs and symptoms suggestive of hyperviscosity syndrome or whenever the monoclonal [[Immunoglobulin M|IgM]] protein spike is > 4 g/dL. | ***Should be measured in patients presenting with signs and symptoms suggestive of hyperviscosity syndrome or whenever the monoclonal [[Immunoglobulin M|IgM]] protein spike is > 4 g/dL. | ||
* '''Mutational analysis''' for the ''[[MYD88]]'' gene, since the MYD88 L265P mutation is found in 90% of patients with Waldenstrom's macroglobulinemia<ref name="pmid23321251">{{cite journal| author=Xu L, Hunter ZR, Yang G, Zhou Y, Cao Y, Liu X et al.| title=MYD88 L265P in Waldenström macroglobulinemia, immunoglobulin M monoclonal gammopathy, and other B-cell lymphoproliferative disorders using conventional and quantitative allele-specific polymerase chain reaction. | journal=Blood | year= 2013 | volume= 121 | issue= 11 | pages= 2051-8 | pmid=23321251 | doi=10.1182/blood-2012-09-454355 | pmc=3596964 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23321251 }} </ref> | * '''Mutational analysis''' for the ''[[MYD88]]'' gene, since the MYD88 L265P mutation is found in 90% of patients with Waldenstrom's macroglobulinemia<ref name="pmid23321251">{{cite journal| author=Xu L, Hunter ZR, Yang G, Zhou Y, Cao Y, Liu X et al.| title=MYD88 L265P in Waldenström macroglobulinemia, immunoglobulin M monoclonal gammopathy, and other B-cell lymphoproliferative disorders using conventional and quantitative allele-specific polymerase chain reaction. | journal=Blood | year= 2013 | volume= 121 | issue= 11 | pages= 2051-8 | pmid=23321251 | doi=10.1182/blood-2012-09-454355 | pmc=3596964 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23321251 }} </ref> | ||
*In patients with peripheral neuropathy, other causes of neuropathy should be ruled out by performing respective tests (as required) for diabetes, cobalamin (vitamin B12) deficiency, thyroid dysfunction, and Lyme disease. | |||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[2]
Overview
Other diagnostic studies for Waldenström macroglobulinemia include nerve conduction study, electromyography, funduscopy, and plasma viscosity.
Other Diagnostic Studies
Other diagnostic studies for Waldenström macroglobulinemia include:
- Nerve conduction study and electromyography, which demonstrates:[1]
- Demyelination with sensory involvement more than motor
- Fundoscopy, which demonstrates:[2]
- Dilated, segmented, and tortuous retinal veins giving a "sausage link" appearance
- Useful in patients with suspected hyperviscosity syndrome
- Dilated, segmented, and tortuous retinal veins giving a "sausage link" appearance
- Plasma viscosity, which demonstrates:[3]
- Values > 1.5 centipoise
- Should be measured in patients presenting with signs and symptoms suggestive of hyperviscosity syndrome or whenever the monoclonal IgM protein spike is > 4 g/dL.
- Values > 1.5 centipoise
- Mutational analysis for the MYD88 gene, since the MYD88 L265P mutation is found in 90% of patients with Waldenstrom's macroglobulinemia[4]
- In patients with peripheral neuropathy, other causes of neuropathy should be ruled out by performing respective tests (as required) for diabetes, cobalamin (vitamin B12) deficiency, thyroid dysfunction, and Lyme disease.
References
- ↑ Nobile-Orazio E, Marmiroli P, Baldini L, Spagnol G, Barbieri S, Moggio M, Polli N, Polli E, Scarlato G (1987). "Peripheral neuropathy in macroglobulinemia: incidence and antigen-specificity of M proteins". Neurology. 37 (9): 1506–14. PMID 2442666.
- ↑ Castillo JJ, Garcia-Sanz R, Hatjiharissi E, Kyle RA, Leleu X, McMaster M; et al. (2016). "Recommendations for the diagnosis and initial evaluation of patients with Waldenström Macroglobulinaemia: A Task Force from the 8th International Workshop on Waldenström Macroglobulinaemia". Br J Haematol. 175 (1): 77–86. doi:10.1111/bjh.14196. PMC 5154335. PMID 27378193.
- ↑ Crawford J, Cox EB, Cohen HJ (1985). "Evaluation of hyperviscosity in monoclonal gammopathies". Am J Med. 79 (1): 13–22. PMID 4014299.
- ↑ Xu L, Hunter ZR, Yang G, Zhou Y, Cao Y, Liu X; et al. (2013). "MYD88 L265P in Waldenström macroglobulinemia, immunoglobulin M monoclonal gammopathy, and other B-cell lymphoproliferative disorders using conventional and quantitative allele-specific polymerase chain reaction". Blood. 121 (11): 2051–8. doi:10.1182/blood-2012-09-454355. PMC 3596964. PMID 23321251.