Multiple myeloma laboratory tests: Difference between revisions

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====Peripheral blood smear====
====Peripheral blood smear====
*Rouleaux formation of red blood cells.
*Rouleaux formation of red blood cells.<ref>Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015</ref><ref>Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015</ref>


====Basic metabolic panel====
====Basic metabolic panel<ref>Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015</ref><ref>Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015</ref>====
* Hypercalcemia due to increased [[osteoclasts]] activity
* Hypercalcemia due to increased [[osteoclasts]] activity
* Raised [[serum creatinine]] level due to reduced [[renal function]]
* Raised [[serum creatinine]] level due to reduced [[renal function]]
Line 23: Line 23:
* High serum [[protein]] level with normal/decreased albumin level
* High serum [[protein]] level with normal/decreased albumin level


====Urinalysis====
====Urinalysis<ref>Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015</ref><ref>Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015</ref>====
*A 24-hour collection of urine is usually needed to examine the amount of protein
*A 24-hour collection of urine is usually needed to examine the amount of protein


====Electrophoresis====
====Electrophoresis<ref>Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015</ref><ref>Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015</ref>====
*Protein electrophoresis is a method that separates proteins in the serum or urine
*Protein electrophoresis is a method that separates proteins in the serum or urine
*70% of people with multiple myeloma have high levels of IgG
*70% of people with multiple myeloma have high levels of IgG
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====Free light chain immunoassay====
====Free light chain immunoassay====
*Potentially offers an improvement in monitoring disease progression and response to treatment.  
*Potentially offers an improvement in monitoring disease progression and response to treatment.<ref>Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015</ref><ref>Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015</ref>


====Immunofixation====
====Immunofixation====
*Specialized type of electrophoresis that identifies the type of M-protein or immunoglobulin light chain detected by serum or urine electrophoresis.
*Specialized type of electrophoresis that identifies the type of M-protein or immunoglobulin light chain detected by serum or urine electrophoresis.<ref>Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015</ref><ref>Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015</ref>


====Quantitative immunoglobulins assay====
====Quantitative immunoglobulins assay<ref>Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015</ref><ref>Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015</ref>====
* Quantitative measurement of IgA, IgG, IgM immunoglobulins to detect immune paresis
* Quantitative measurement of IgA, IgG, IgM immunoglobulins to detect immune paresis
* Monoclonal gammopathy (IgA and/or IgG peak)
* Monoclonal gammopathy (IgA and/or IgG peak)
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====Immunohistochemistry====  
====Immunohistochemistry====  
*Multiple myeolma cells are typically [[CD56]], [[CD38]], [[CD138]] positive and [[CD19]] and [[CD45]] negative.
*Multiple myeolma cells are typically [[CD56]], [[CD38]], [[CD138]] positive and [[CD19]] and [[CD45]] negative.<ref>Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015</ref><ref>Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015</ref>


==References==
==References==

Revision as of 17:45, 21 September 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Laboratory findings consistent with the diagnosis of multiple myeloma include abnormal complete blood count, erythrocyte sedimentation rate (ESR), basic metabolic panel, electrophoresis and immunohistochemistry. An elevated concentration of serum protein level without concomitant elevation of serum albumin level is very suggestive of multiple myeloma.[1][2]


Laboratory Findings

Complete blood count[3][4]

Peripheral blood smear

  • Rouleaux formation of red blood cells.[5][6]

Basic metabolic panel[7][8]

Urinalysis[9][10]

  • A 24-hour collection of urine is usually needed to examine the amount of protein

Electrophoresis[11][12]

  • Protein electrophoresis is a method that separates proteins in the serum or urine
  • 70% of people with multiple myeloma have high levels of IgG
  • 20% of people with multiple myeloma have high levels of IgA
  • 5–10% of people with multiple myeloma produce only immunoglobulin light chains (Bence Jones proteins)
  • Rarely κ- or λ-light chains may be secreted in isolation.

Free light chain immunoassay

  • Potentially offers an improvement in monitoring disease progression and response to treatment.[13][14]

Immunofixation

  • Specialized type of electrophoresis that identifies the type of M-protein or immunoglobulin light chain detected by serum or urine electrophoresis.[15][16]

Quantitative immunoglobulins assay[17][18]

  • Quantitative measurement of IgA, IgG, IgM immunoglobulins to detect immune paresis
  • Monoclonal gammopathy (IgA and/or IgG peak)
  • Reverse albumin:globulin ratio (low albumin, high globulin)
  • Elevated β2-microglobulin level

Immunohistochemistry

References

  1. ↑ Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  2. ↑ Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015
  3. ↑ Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  4. ↑ Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015
  5. ↑ Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  6. ↑ Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015
  7. ↑ Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  8. ↑ Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015
  9. ↑ Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  10. ↑ Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015
  11. ↑ Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  12. ↑ Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015
  13. ↑ Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  14. ↑ Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015
  15. ↑ Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  16. ↑ Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015
  17. ↑ Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  18. ↑ Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015
  19. ↑ Multiple myeloma. Canadian Cancer Society(2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/diagnosis/?region=mb#blood_chem Accessed on September, 20th 2015
  20. ↑ Multiple myeloma. Wikipedia (2015)https://en.wikipedia.org/wiki/Multiple_myeloma#Pathophysiology Accessed on September 2015


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