Waldenström's macroglobulinemia history and symptoms: Difference between revisions
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Waldenström's macroglobulinemia is asymptomatic in 30% of patients.<ref name="HS">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</ref> | Waldenström's macroglobulinemia is asymptomatic in 30% of patients.<ref name="HS">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</ref> | ||
==Symptomatic Waldenström's | ==Symptomatic Waldenström's Macroglobulinemia== | ||
===Constitutional symptoms=== | ===Constitutional symptoms=== | ||
*Weight loss<ref name="HS">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</ref><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> | *Weight loss<ref name="HS">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</ref><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> | ||
Revision as of 18:40, 18 November 2015
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Waldenström's macroglobulinemia Microchapters |
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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
The hallmark of Waldenström's macroglobulinemia is hyperviscosity syndrome. A positive history of oronasal bleeding and peripheral neuropathy is suggestive of Waldenström's macroglobulinemia.[1][2]
History
When evaluating a patient suspected of Waldenström's macroglobulinemia, you should take a detailed history of the presenting symptoms (duration, onset, progression), a thorough past medical history review, and a review of any other associated symptoms. When obtaining the history focus on a possible associated syndromes such as:[1][2]
- Hyperviscosity syndrome
- Peripheral neuropathy
- Cryoglobulinemia
- Renal involvement
- Gastrointestinal involvement
Asymptomatic or Smoldering Waldenström's Macroglobulinemia
Waldenström's macroglobulinemia is asymptomatic in 30% of patients.[1]
Symptomatic Waldenström's Macroglobulinemia
Constitutional symptoms
- Weight loss[1][2]
- 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 hyperviscosity syndrome occur if serum viscosity is >4 centipoises
Neurological Symptoms of hyperviscosity
Vascular symptom
- Oronasal bleeding
Neuropathic symptoms
- Most prominent neuropathic symptom of Waldenström's macroglobulinemia is progressive sensorimotor peripheral neuropathy, mostly involving distal lower extremity.
- Symptoms 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 Cryoglobulinemia 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 papules on extensor surface
References
- ↑ 1.0 1.1 1.2 1.3 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
- ↑ 2.0 2.1 2.2 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