Waldenström's macroglobulinemia history and symptoms: Difference between revisions
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===Neuropathic symptoms=== | ===Neuropathic symptoms=== | ||
*Most prominent neuropathic symptom of | *Most prominent neuropathic symptom of waldenström's macroglobulinemia is progressive sensorimotor [[peripheral neuropathy]], mostly involving distal lower extremity. | ||
*Symptoms are associated with | *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. | *Less common neuropathic manifestations are [[cranial nerve palsies]], [[mononeuropathy]], [[mononeuritis multiplex]], multifocal leukoencephalopathy, and sudden deafness. | ||
Revision as of 21:02, 6 January 2016
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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 manifestations 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 García-Sanz R, Montoto S, Torrequebrada A, de Coca AG, Petit J, Sureda A, Rodríguez-García JA, Massó P, Pérez-Aliaga A, Monteagudo MD, Navarro I, Moreno G, Toledo C, Alonso A, Besses C, Besalduch J, Jarque I, Salama P, Rivas JA, Navarro B, Bladé J, Miguel JF (2001). "Waldenström macroglobulinaemia: presenting features and outcome in a series with 217 cases". Br. J. Haematol. 115 (3): 575–82. PMID 11736938.